dc.contributor.author |
Thomas, Mark |
en |
dc.contributor.author |
Hopkins, C |
en |
dc.contributor.author |
Duffy, Eamon |
en |
dc.contributor.author |
Lee, D |
en |
dc.contributor.author |
Loulergue, P |
en |
dc.contributor.author |
Ripamonti, D |
en |
dc.contributor.author |
Ostrov, DA |
en |
dc.contributor.author |
Phillips, E |
en |
dc.date.accessioned |
2017-08-17T02:07:09Z |
en |
dc.date.issued |
2017-05-01 |
en |
dc.identifier.citation |
Clinical Infectious Diseases 64(9):1198-1203 01 May 2017 |
en |
dc.identifier.issn |
1058-4838 |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/35166 |
en |
dc.description.abstract |
Background. Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare, severe adverse event during treatment with raltegravir. The occurrence of DRESS syndrome during treatment with other drugs is strongly associated with particular HLA alleles. Methods. We performed HLA testing in 3 of the 5 patients previously reported to have developed raltegravir-induced DRESS syndrome and in 1 previously unreported patient. We then used virtual modeling to visualize interactions between raltegravir and the imputed HLA molecule. Results. Five of the 6 patients who developed raltegravir-induced DRESS syndrome were African, and 1 was Hispanic. HLA typing was performed in 4 patients, all of whom carried both the HLA-B*53 allele and the HLA-C*04 allele to which it is commonly haplotypic. No other HLA alleles were shared by all of the tested patients. Given the approximate prevalence of HLA-B*53 carriage in African (20%) and Hispanic (6%) populations, the probability of all 4 patients being HLA-B*53 carriers, and 2 of 3 African patients being homozygous for HLA-B*53:01, is approximately 0.00002. Conclusions. These data implicate the prevalent African allele HLA-B*53:01 in the immunopathogenesis of raltegravir-induced DRESS syndrome. Although the immunopathogenic mechanisms are currently unknown, virtual modeling suggests that raltegravir may bind within the antigen binding cleft of the HLA-B*53:01 molecule, but not within the closely related HLA-B*35:01 molecule. Further studies are necessary to confirm the strength of the association between carriage of the HLA-B*53:01 allele and raltegravir-induced DRESS syndrome, and the potential utility of HLA screening before raltegravir treatment. |
en |
dc.publisher |
University of Chicago Press |
en |
dc.relation.ispartofseries |
Clinical Infectious Diseases |
en |
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.title |
Association of the HLA-B*53:01 Allele With Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome During Treatment of HIV Infection With Raltegravir |
en |
dc.type |
Journal Article |
en |
dc.identifier.doi |
10.1093/cid/cix096 |
en |
pubs.issue |
9 |
en |
pubs.begin-page |
1198 |
en |
pubs.volume |
64 |
en |
dc.rights.holder |
Copyright: The author |
en |
pubs.end-page |
1203 |
en |
pubs.publication-status |
Published |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/RestrictedAccess |
en |
pubs.subtype |
Article |
en |
pubs.elements-id |
631861 |
en |
pubs.org-id |
Medical and Health Sciences |
en |
pubs.org-id |
Medical Sciences |
en |
pubs.org-id |
Molecular Medicine |
en |
dc.identifier.eissn |
1537-6591 |
en |
pubs.record-created-at-source-date |
2017-08-17 |
en |
pubs.online-publication-date |
2017-03-21 |
en |
pubs.dimensions-id |
28369189 |
en |