HLA-B57

Disease

HLA-B*5701 is associated with drug-induced inflammatory disease of the skin. Individuals with B57 are more sensitive to the drug abacavir. Abacavir is an antiretroviral drug used in treatment of HIV, however in sensitive individuals fever, skin rash, fatigue, gastrointestinal symptoms such as nausea, vomiting, diarrhea or abdominal pain and respiratory symptoms such as pharyngitis, dyspnea, or cough can develop. FDA has advised that people from at-risk ethnic groups, (see alle distribution table) be screened prior to drug-therapy. [Note: phenotype frequencies are roughly double allele frequencies -tabled values- when allele frequency is less than 30%]

The mechanism by which abacavir causes this type 4 hypersensitivity reaction is by binding in the antigen-binding cleft of the HLA-B*57:01 protein, allowing new, "non-self" antigens to bind and be presented to T cells.

Serotype

Allele distribution

References

References

1. (2010). "Nomenclature for factors of the HLA system, 2010". Tissue Antigens.
2. (1985). "The complete primary structure of HLA-Bw58". J. Biol. Chem..
3. (August 2007). "Human leukocyte antigens and drug hypersensitivity". Curr Opin Allergy Clin Immunol.
4. [https://web.archive.org/web/20080916141240/http://www.fda.gov/cder/drug/InfoSheets/HCP/abacavirHCP.htm fda.gov] FDA abacavir alert web access July 29, 2008
5. (2012-06-28). "Immune self-reactivity triggered by drug-modified HLA-peptide repertoire". Nature.
6. [http://www.ebi.ac.uk/imgt/hla/allele.html derived from IMGT/HLA]
7. (2003). "New allele frequency database". Tissue Antigens.