TABLE 4.
HLA associations in SCAR and DILI with possible clinical implications.
| Reference | Reaction type | Drug | HLA | Ethnicity | Screening | NPV (%) | PPV (%) | NNT |
|---|---|---|---|---|---|---|---|---|
| (Konvinse et al. (2019)) | DRESS | Vancomycin | A*32:01 | European ancestry (6.8%) | Pre-emptive♣ | 99.99 | 0.51 | 75 |
| African American (4%) | ||||||||
| Southeast Asian (<1.5%) | ||||||||
| (Daly et al., (2009)) | DILI | Flucloxacillin | B*57:01 | European ancestry (5–8%) | None | 99.99 | 0.14 | 13,819 |
| African American (2.5%) | ||||||||
| African/Asia (<1%) | ||||||||
| (Mallal et al. (2002)) | AB HS | Abacavir | B*57:01 | Caucasian (5–8%) | HIV positive patients | 100 | 55 | 13 |
| (Hung et al. (2005)) | SJS/TEN | Allopurinol | B*58:01 | Han Chinese (9–11%) | None | 100 | 3 | 250 |
| DRESS | Caucasian (1–6%) | |||||||
| (Zhang et al. (2013)) | SJS/TEN | Carbamazepine | B*15:02ψ | Han Chinese (10–15%) | Routine in southeast Asian countries | 100 | 3 | 1,000 |
| (Zhang et al. (2013)) | DRESS | Dapsone | B*13:01 | Papuans/Australian aborigines (28%) | Leprosy patients in countries with increased prevalence | 99.8 | 7.8 | 84 |
| Chinese (2–20%) | ||||||||
| Japanese (1.5%) | ||||||||
| Indian (1–12%) |
AB HS, abacavir hypersensitivity syndrome; DILI, drug-induced liver injury; DRESS, drug reaction with eosinophilia and systemic symptoms; HIV, human immunodeficiency virus; NNT, numbers needed to test (to prevent one case); NPV, negative predictive value; PPV, positive predictive value; SJS/TEN, SJS/TEN, Stevens-Johnson syndrome/toxic epidermal necrolysis. ♣ HLA-A*32:01 testing could have a role in determining the culprit drug (vancomycin) when multiple drugs are implicated in a delayed hypersensitivity reaction.ψ Other described alleles: HLA-B*15:21, HLA-B*15:11, and HLA-B*15:18.