HLA and Drug Reactions

TL;DRAbstract

Adverse drug reactions represent a significant burden from a hospital, healthcare and societal perspective comprising the 4th to 6th most common cause of death in some series. Clinically, adverse drug reactions have been classified according to those that are predictable and dose-dependent on the basis of their pharmalogical actions (Type A) versus those that are believed to be immunogenetically mediated and not predictable based on traditional clinical and pharmalogical properties of the drug (Type B) (Table 20.1). A major breakthrough has been the association between HLA class I and II alleles and Type B adverse drug reactions. Examples include the striking association between HLA-B*5701 and abacavir hypersensitivity syndrome (ABC HSR), HLA-B*1502 and Stevens-Johnson syndrome/Toxic epidermal necrolysis (SJS/TEN) associated with carbamazepine, and HLA-B*5801 and drug-induced hypersensitivity syndrome (DIHS) and SJS/TEN associated with allopurinol. These associations have been facilita

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