Table 3.
Human leukocyte antigen associations for antimicrobial associated T-cell-mediated hypersensitivity syndromes
| Antimicrobial | Clinical Presentation | Associated HLA allele(s) | Population | NPV | PPV | NNT |
|---|---|---|---|---|---|---|
| Abacavir | Hypersensitivity syndrome (fever, rash, GI distress, malaise) | HLA-B*57:01 | European, African | 100% for patch test confirmed | 55% | 13 |
| Efavirenz | Rash | HLA-DRB1*01 | French | |||
| Nevirapine | Rash | HLA-B*35:05 HLA*Cw4 |
Thai African, Asian, European, Thai |
97% | 16% | |
| DRESS | HLA-B*14/Cw8 HLA-Cw8 HLA-Cw*4 and HLA- DRB1*15 HLA-B*3505 HLA-B*3501 and HLA- B*15/DRB1*15 |
Italian Japanese Han Chinese Asian Australian |
||||
| Hepatitis | HLA-DRB1*01:01 HLA-DRB1*01:02 |
Australian, European South African |
96% | 18% | ||
| SJS/TEN | HLA-C*04:01 | Malawian | ||||
| Dapsone | Rash, hepatitis | HLA-B*13:01 | Chinese | 99.8% | 7.8% | 84 |
| Flucloxacillin | Hepatitis (DILI) | HLA-B*57:01 HLA-DRB1*0107- DQB1*0103 |
European | 99.99% | 0.12% | 13.819 |
| Amoxicillin- clavulanate; coamoxiclav | Hepatitis (cholestatic) | HLA*02:01 HLA-DQB1*0602 and rs3135388, a tag SNP of HLA-DRB*15:01- DQB1*06:02 |
European | |||
| Sulfamethoxazole | SJS/TEN | HLA-B*38 | European | |||
| FDE | HLA-A*30-B*14-Cw*6 haplotype | Turkish | ||||
| Aminopenicillins | Rash | HLA-A*2 HLA-DR*52 |
Italian | |||
| Sulphonamides | SJS/TEN | HLA-A*29 HLA-B*12 HLA-DR7 |
European | |||
| Isoniazid | DILI | NAT2 slow acetylator, CYP2E1*5 and *1B |
European | |||
| Drug-induced lupus erythematous | HLA-DR*4 | Italian | ||||
| Levamisole | Agranulocytosis | HLA-B*27 | South American |
Abbreviations: DILI, drug-induced liver injury; DRESS, drug reaction with eosinophilia and systemic symptoms; GI, gastrointestinal; HLA, human leukocyte antigen; NNT, number needed to treat; NPV, negative predictive value; PPV, positive predictive value; SJS/TEN, Stevens-Johnson Syndrome/Toxic epidermal necrolysis References: [196–221]