Association of HLA-B∗35 and moderate or severe cutaneous reactions secondary to benznidazole treatment in chronic chagas disease
| Autor: | P. Bosch-Nicolau, Sílvia Roure, N. Serre-Delcor, Ll Valerio, D. Pou, J. Espinosa-Pereiro, B. Treviño, I. Oliveira-Souto, I. Arrese-Muñoz, A. Sánchez-Montalvá, Elena Sulleiro, C. Franco-Jarava, M.L. Aznar, Israel Molina, Fernando Salvador |
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| Rok vydání: | 2021 |
| Předmět: |
Microbiology (medical)
Chagas disease Adult Male medicine.medical_specialty Internal medicine Statistical significance Medicine Eosinophilia Humans Chagas Disease Hypersensitivity Delayed Adverse effect Genotyping Skin business.industry General Medicine Middle Aged medicine.disease Discontinuation Infectious Diseases Benznidazole HLA-B Antigens Nitroimidazoles Female medicine.symptom business Pharmacogenetics medicine.drug |
| Zdroj: | Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases. 28(6) |
| ISSN: | 1469-0691 |
| Popis: | Objectives Benznidazole is the first line treatment for Chagas disease. Adverse events appear in more than 50% of patients, leading to discontinuation in approximately 15%. Cutaneous reactions are one of the most frequent adverse events. HLA-genotyping previous studies identified an association between cutaneous reactions to benznidazole and carrying the specific allele HLA-B*35:05. We designed the present study to prospectively confirm this association. Methods This is a prospective observational study including Chagas disease patients aged 18 years or more who accepted to receive benznidazole treatment following current guidelines. Allele genotyping of HLA-B was determined in all patients. Clinical and analytical follow-up was performed at days 0, 7, 14, 30 and 60 of treatment. Results Two-hundred and seven patients were included. Seventy percent were female with a mean age of 45.1 (SD ±9.86) years mainly from Bolivia (92.8%). In 102 (49.3%) cases a cutaneous reaction was diagnosed. Forty-eight (46.6%) were classified as mild, 37 (35.9%) as moderate and 18 (17.5%) as severe. Thirty-two (15.4%) patients had to definitively interrupt the treatment due to a cutaneous reaction. Female sex (OR 4.49; 95%CI 1.62-12.47), new-onset eosinophilia prior to cutaneous symptoms (OR 2.55; 95%CI 1.2-5.43) and carrying the HLA-B*35 allelic group (OR 2.58; 95%CI 1.2-5.51) were all predictors of moderate to severe cutaneous reactions. No statistical significance was found when the specific allele HLA-B*35:05 was analyzed. Conclusions Patients carrying the HLA-B*35 allelic group are at higher risk of moderate to severe reactions when taking benznidazole treatment. |
| Databáze: | OpenAIRE |
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