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HLA-B*57:01 significantly increases the risk of hypersensitivity reactions when abacavir is administered. Approximately 6% of Caucasians and 2-3% of African Americans carry this allele in the human leukocyte antigen B (HLA-B) gene. The HLA-B gene plays an important role in how the immune system recognizes and responds to pathogens, and mediates hypersensitivity reactions. HLA-B*57:01 has been found to be associated with abacavir hypersensitivity across different ethnicities, including Caucasians, Hispanics, and individuals of African origin (2, 3).
Abacavir can trigger a hypersensitivity reaction in people who have the HLA-B*57:01 allele. The frequency of the HLA-B*57:01 allele varies by population; for example, approximately 6% of Caucasians, and 2-3% of African-American and admixed American populations carry at least one copy of this high-risk HLA-B allele (Table 4). HLA-B*57:01-postitive individuals have an increased risk of a hypersensitivity reaction to abacavir compared to HLA-B*57:01-negative individuals (8).
If tests are performed for HLA-B57 instead of HLA-B*57:01, some patients will incorrectly be denied treatment with abacavir. This is primarily the case in patients of African descent, where HLA-B*57:03 is the most common HLA-B57 sub-type and to a lesser extent for Caucasian patients, where HLA-B*57:01 is the most common HLA-B57 sub-type. If there are enough alternatives, it is not a problem that the patient is being denied abacavir incorrectly. 2b1af7f3a8