Abacavir hypersensitivity

Educate the patient on common adverse drug effects and a few of the key signs and symptoms of severe toxicity (i.e., jaundice and abacavir hypersensitivity reaction). Tell them to call their provider immediately if any of those symptoms occur. Make sure they have the correct telephone number for the clinic. 

Potential tenofovir nephrotoxicity in susceptible patients Abacavir hypersensitivity in 5% of patients... 

Abacavir hypersensitivity reaction registry - Physicians should register patients by calling (800) 270-0425. 

Dispense a Medication Guide and Warning Card that provide information about recognition of hypersensitivity reactions with each new prescription or refill. To facilitate reporting hypersensitivity reactions and collection of information on each case, an Abacavir Hypersensitivity Registry has been established. Physicians should register patients by calling (800) 270-0425. 

Martin AM, Nolan D, Gaudieri S, Almeida CA, et al. 2004. Predisposition to abacavir hypersensitivity conferred by HLA-B 57021 and a haplotypic Hsp70-Hom variant. Proc Natl Acad Sci USA. 101 4180-4185. 

Genetic factors affecting the immune response to abacavir have been sought in patients who had taken abacavir for more than 6 weeks, 18 with hypersensitivity reactions and 167 without (16). HLA-B 5701 was present in 14 of the 18 patients with abacavir hypersensitivity, and in four of the 167 others (OR = 117 95% Cl = 29, 481). The combination of HLA-DR7 and... 

Loeliger AE, Steel H, McGuirk S, Powell WS, Hetherington SV. The abacavir hypersensitivity reaction and interruptions in therapy. AIDS 2001 15(10) 1325-6. 

In an open 48-week, single-arm, multicenter phase II study in 99 patients abacavir 300 mg bd, amprenavir 1200 mg bd, and efavirenz 600 mg/day were associated with rashes in 50 patients, possibly because of abacavir hypersensitivity 17 permanently discontinued one or more drugs as a result (9). Other adverse effects included nausea (n = 41), diarrhea (n = 27), sleep disorders (n = 27), dizziness (n = 25), fatigue (n = 23), hypertriglyceridemia (n = 18), neutropenia (n = 8), hyperamyla-semia (n = 4), leukopenia n = 3), hypercholesterolemia (n = 2), raised alkaline phosphatase (n = V), and raised aspartate transaminase (n = 1). 

Case Conclusion Based on GL s history of nonadherence and his symptoms of rash, nausea, and vomiting, abacavir hypersensitivity is suspected and the agent is discontinued. The symptoms most commonly associated with abacavir hypersensitivity reaction are fever, rash, Gl effects (nausea, vomiting, diarrhea, or abdominal pain), lethargy or malaise, and upper or lower respiratory effects. The majority of symptoms include either fever or rash and laboratory abnormalities may include elevated LFTs, increased creatine phosphokinase or Cr, and lymphopenia. Another nucleoside analogue is started and his symptoms resolve. He is counseled on the importance of adherence, especially when he travels. 

Hughes AR, Brothers CH, Mosteller M, et al. Genetic association studies to detect adverse drug reactions Abacavir hypersensitivity as an example. Pharmacogenomics. 2009 10(2) 225-233. 

Multiple genes Abacavir Hypersensitivity cases HLA-B57 was present in 39 (46%) of 84 patients with hypersensitivity versus four (4%) of 113 controls (without hypersensitivity) 59... 

Human leukocyte antigen Abacavir Hypersensitivity reactions... 

Hughes DA, Vilar FJ, Ward CC, Aifirevic A, Park BK, Pirmohamed M (2004b) Cost-effectiveness analysis of HLA B 5701 genotyping in preventing abacavir hypersensitivity. Pharmacogenetics 14 335-342... 

Mank-Seymour AR, Richmond JL, Wood LS, Reynolds JM, Fan YT, Wames GR, Milos PM, Thompson JF (2006) Association of torsades de pointes with novel and known single nucleotide polymorphisms in long QT syndrome genes. Am Heart J 152 1116-1122 Martin AM, Nolan D, Gaudieri S, Almeida CA, Nolan R, James I, Carvalho F, Phillips E, Christiansen FT, Purcell AW, McCluskey J, Mallal S (2004) Predisposition to abacavir hypersensitivity conferred by HLA-B 5701 and a haplotypic Hsp70-Hom variant. Proc Natl Acad Sci U S A 101 4180-4185... 

Waters LJ, Mandalia S, Gazzard B, Nelson M (2007) Prospective HLA-B 5701 screening and abacavir hypersensitivity a single centre experience. AIDS 21 2533-2534 Wellcome Tmst Case Control Consortium (2007) Genome-wide association study of 14,000 cases of seven common diseases and 3, 000 shared controls. Nature 447 661-678 Wilke RA, Lin DW, Roden DM, Watkins PB, Flockhart D, Zineh I, Giacomini KM, Krauss RM... 

Zucman D, Trachis P, Majerholc C, Stegman S, Caillat-Zucman S (2007) Prospective screening for human leukocyte antigen-B 5701 avoids abacavir hypersensitivity reaction in the ethnically mixed French HTV population. J Acquir Immune Defic Syndr 45 1-3... 

The application of genomics promises to better explain and ultimately reduce some ADRs. Results so far have demonstrated the association in Han Chinese of carbamazepine-indnced Stevens-Johnson syndrome with the HLA-B 15 02 allele and the association of abacavir hypersensitivity in AHS with HLA-B 57 01. 

Susceptibility factors Genetic The association of HLA B 5701 with the risk of abacavir hypersensitivity skin reactions has been repeatedly reviewed [95, 96, 97, 98, 99 ]. It provides an excellent example of the successful translation of a pharmaco-genetic test into clinical practice and affords insights into why other tests have not been successful [100 ]. However, testing may not be necessary in all communities for example of 534 Koreans none had the HLA B 5701 polymorphism [101 =] this suggests that the incidence of hypersensitivity in this population is hkely to be less than 0.6%, and testing would not be cost-effective. 

Narciso P. Parsonage-Turner syndrome a rare case of abacavir hypersensitivity reaction in HIV-infected patients. J Infect 2008 57(1) 88-90. 

Lai-Goldman M, Faruki H. Abacavir hypersensitivity a model system for phar-macogenetic test adoption. Genet Med 2008 10(12) 874-8. 

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