Prevalence of Abacavir Hypersensitivity Reaction and Cost-Effectiveness of HLA-B*5701 Screening: A Ten-Year Experience in The HRH Princess Maha Chakri Sirindhorn Medical Center

Background: Recently, the authors had reported a case with abacavir hypersensitivity reaction (ABC-HSR), the first diagnosed patient at the HRH Princess Maha Chakri Sirindhorn Medical Center (MSMC). There was no data regarding the incidence or prevalence of ABC-HSR previously reported in Thailand. Objective: To study the prevalence of ABC-HSR, the abacavir use pattern and the cost effectiveness for the routine human leukocyte antigen (HLA)-B*5701 screening before abacavir use by analyses of the MSMC data. Materials and Methods: All patients at the MSMC who were prescribed abacavir from October 1, 2010 to September 30, 2020 were retrospectively reviewed for ABC-HSR and the abacavir use pattern at the time when abacavir was started. The cost-effectiveness analysis was applied by analyzing the cost between the routine HLA-B*5701 screening before abacavir use and the HLA-B*5701 confirmation for ABC-HSR. The cost for the prevention of a case of ABC-HSR was defined. Results: There were total of 54 patients who were prescribed abacavir and only one ABC-HSR case diagnosed. The prevalence of ABC-HSR was 1.85%. The main reason for the abacavir prescription was a substitution for tenofovir (TDF) because of the TDF adverse effects (81.13%). The HLA-B*5701 screening before abacavir use was done in 26.42% at the MSMC. If all eligible patients were routinely screened for the HLA-B*5701 allele before abacavir use, the cost would be 54,000 Baht. The cost for the diagnosis and the management of the ABC- HSR case was 7,230 Baht. The cost for the prevention of a case of ABC-HSR was 46,770 Baht. Conclusion: The prevalence of ABC-HSR was low. The main reason for abacavir use was a substitution for TDF. The cost for the prevention for a case of ABC-HSR was 46,770 Baht which would be less if the cost for the HLA-B*5701 test was reduced. Keywords: Abacavir; Hypersensitivity reaction; Prevalence; HLA-B*5701

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HLA class I alleles are associated with clinic-based migraine and increased risks of chronic migraine and medication overuse

Cephalalgia ◽

10.1177/0333102420902228 ◽

2020 ◽

Vol 40 (5) ◽

pp. 493-502

Author(s):

Claire Huang ◽

Shih-Pin Chen ◽

Yu-Han Huang ◽

Hsuan-Yu Chen ◽

Yen-Feng Wang ◽

...

Keyword(s):

Human Leukocyte Antigen ◽

Chronic Migraine ◽

Medication Overuse ◽

Medical Center ◽

Medication Overuse Headache ◽

Human Leukocyte ◽

Population Based ◽

Class I ◽

Leukocyte Antigen ◽

Antigen B

Objective We aimed to evaluate associations of human leukocyte antigen variants with migraine or headache in hospital and population-based settings. Methods The case-control study population, aged 30–70, included 605 clinic-based migraine patients in a medical center and 8449 population-based participants in Taiwan Biobank (TWB). Clinic-based cases were ascertained by neurologists. Participants in Taiwan Biobank were interviewed by a structured questionnaire including headache and migraine history; among them, 2394 had headache or migraine history while 6055 were free of headache and served as controls. All subjects were genotyped by Axiom Genome-Wide Single Nucleotide Polymorphism Arrays and imputed for eight classical human leukocyte antigen genes. Human leukocyte antigen frequencies were compared between clinic-based and self-reported patients and controls. We utilized likelihood ratio tests to examine human leukocyte antigen-disease associations and logistic regressions to estimate the effect of human leukocyte antigen alleles on migraine. Results Human leukocyte antigen -B and C showed significant associations with clinic-based migraine ( q-value < 0.05). Human leukocyte antigen -B*39:01, human leukocyte antigen -B*51:01, human leukocyte antigen -B*58:01 and human leukocyte antigen -C*03:02 were significantly associated with migraine, with age and sex-adjusted odds ratios (95% CIs) of 1.80 (1.28–2.53), 1.50 (1.15–1.97), 1.36 (1.14–1.62) and 1.36 (1.14–1.62), correspondingly. Clinic-based migraineurs carrying human leukocyte antigen -B*58:01 or human leukocyte antigen -C*03:02 had 1.63 (1.11–2.39) -fold likelihood to have chronic migraine with medication-overuse headache compared to episodic migraine. However, no human leukocyte antigen genes were associated with self-reported headache or migraine in the community. Conclusions Human leukocyte antigen class I genetic variants are positively associated with risk of clinic-based migraine but not self-reported migraine or headache and may contribute to migraine chronification and medication overuse.

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Adverse effects of human leukocyte antigen-DR sharing on fertility: a cohort study in a human isolate**Supported by National Institutes of Health grants NO1-HD-02840, RO1-CA-19822, GM-10356, A1-08897, P30-CA-15145, and Biomedical Sciences Support grant 5-S05 RR07028, and Biomedical Research Support grant from the Dean’s Office, Northwestern University Medical School.

Fertility and Sterility ◽

10.1016/s0015-0282(16)48742-x ◽

1985 ◽

Vol 44 (2) ◽

pp. 227-232 ◽

Cited By ~ 27

Author(s):

Carole L. Ober ◽

Walter W. Hauck ◽

Donna D. Kostyu ◽

Elizabeth O’Brien ◽

Sherman Elias ◽

...

Keyword(s):

Cohort Study ◽

Adverse Effects ◽

Human Leukocyte Antigen ◽

Biomedical Research ◽

Human Leukocyte ◽

National Institutes Of Health ◽

Biomedical Sciences ◽

Research Support ◽

Leukocyte Antigen ◽

Northwestern University

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A human leukocyte antigen locus haplotype confers risk for allopurinol-related adverse effects in Caucasian patients with gout

Pharmacogenetics and Genomics ◽

10.1097/fpc.0000000000000147 ◽

2015 ◽

Vol 25 (8) ◽

pp. 412-415 ◽

Cited By ~ 7

Author(s):

Rebecca L. Roberts ◽

Mary C. Wallace ◽

Andrew Harrison ◽

Nicola Dalbeth ◽

Tony R. Merriman ◽

...

Keyword(s):

Adverse Effects ◽

Human Leukocyte Antigen ◽

Human Leukocyte ◽

Leukocyte Antigen ◽

Caucasian Patients ◽

Human Leukocyte Antigen Locus

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Comparing the cost-per-QALYs gained and cost-per-DALYs averted literatures

Gates Open Research ◽

10.12688/gatesopenres.12786.2 ◽

2018 ◽

Vol 2 ◽

pp. 5 ◽

Cited By ~ 1

Author(s):

Peter J. Neumann ◽

Jordan E. Anderson ◽

Ari D. Panzer ◽

Elle F. Pope ◽

Brittany N. D'Cruz ◽

...

Keyword(s):

Cost Effectiveness ◽

English Language ◽

Medical Center ◽

Quality Adjusted Life Year ◽

Cost Effectiveness Analysis ◽

Middle Income ◽

Effectiveness Analysis ◽

Global Cost ◽

Study Characteristics ◽

The Cost

Background: We examined the similarities and differences between studies using two common metrics used in cost-effectiveness analyses (CEAs): cost per quality-adjusted life year (QALY) gained and cost per disability-adjusted life year (DALY) averted. Methods: We used the Tufts Medical Center CEA Registry, which contains English-language cost-per-QALY gained studies, and the Global Cost-Effectiveness Analysis (GHCEA) Registry, which contains cost-per-DALY averted studies. We examined study characteristics, including intervention type, sponsor, country, and primary disease, and also compared the number of published CEAs to disease burden for major diseases and conditions across geographic regions. Results: We identified 6,438 cost-per-QALY and 543 cost-per-DALY studies published through 2016 and observed rapid growth for both literatures. Cost-per-QALY studies most often examined pharmaceuticals and interventions in high-income countries. Cost-per-DALY studies predominantly focused on infectious disease interventions and interventions in low and lower-middle income countries. We found that while diseases imposing a larger burden tend to receive more attention in the cost-effectiveness analysis literature, the number of publications for some diseases and conditions deviates from this pattern, suggesting “under-studied” conditions (e.g., neonatal disorders) and “over-studied” conditions (e.g., HIV and TB). Conclusions: The CEA literature has grown rapidly, with applications to diverse interventions and diseases. The publication of fewer studies than expected for some diseases given their imposed burden suggests funding opportunities for future cost-effectiveness research.

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Prospective Screening for Human Leukocyte Antigen-B*5701 Avoids Abacavir Hypersensitivity Reaction in the Ethnically Mixed French HIV Population

JAIDS Journal of Acquired Immune Deficiency Syndromes ◽

10.1097/qai.0b013e318046ea31 ◽

2007 ◽

Vol 45 (1) ◽

pp. 1-3 ◽

Cited By ~ 104

Author(s):

David Zucman ◽

Pierre de Truchis ◽

Catherine Majerholc ◽

Sophia Stegman ◽

Sophie Caillat-Zucman

Keyword(s):

Hypersensitivity Reaction ◽

Human Leukocyte Antigen ◽

Human Leukocyte ◽

Leukocyte Antigen ◽

Antigen B

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COST-EFFECTIVENESS OF HUMAN LEUKOCYTE ANTIGEN MATCHING IN PENETRATING KERATOPLASTY

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462313000603 ◽

2014 ◽

Vol 30 (1) ◽

pp. 50-58 ◽

Cited By ~ 2

Author(s):

Michael Bäumler ◽

Leonie Sundmacher ◽

Thomas Reinhard ◽

Daniel Böhringer

Keyword(s):

Cost Effectiveness ◽

Human Leukocyte Antigen ◽

Incremental Cost ◽

Graft Survival ◽

Expert Opinion ◽

Penetrating Keratoplasty ◽

Causal Effect ◽

Human Leukocyte ◽

Hla Matching ◽

Leukocyte Antigen

Background: The matching of favorable human leukocyte antigen (HLA) combinations is rarely performed in penetrating keratoplasty procedures for primary prophylaxis of immune reactions. However, clinical studies suggest that the incidence of graft rejection decreases substantially when patients receive favorably matched grafts.Objective: The aim of this study was to assess the cost-effectiveness of HLA matching for patients undergoing penetrating keratoplasty in everyday clinical practice.Methods: In the absence of a randomized controlled clinical trial, we used administrative data from the Freiburg University Eye Hospital in Germany. Our study population consisted of all patients who underwent their first keratoplasty between 11/2003 and 01/2010 and for whom information on HLA histocompatibility was available. We used propensity score matching to estimate a causal effect of favorable HLA matching, parametric survival regression techniques to predict graft survival and expert opinion to model incremental cost for HLA matching. Because the availability of favorable HLA histocompatibility ultimately depends on the patients’ HLA phenotype, we modeled the incremental cost-effectiveness ratio (ICER) as a function of the probability that a patient will receive a favorably matched HLA, and used expert opinion to set a point estimate.Results: We predicted that corneal grafts with favorable HLA matching were associated with improved rejection-free graft survival time (more than 1,000 days). We estimated the incremental cost of HLA matching at EUR 1,200 and the ICER at EUR 4.62 per additional day of graft survival.Conclusions: The ICER of HLA matching is acceptable, given the high cost of alternative treatment and the shortage of corneal donors in Germany.

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