Publication: 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
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Issued Date
2021
Resource Type
Language
eng
File Type
application/pdf
ISSN
1252208
Other identifier(s)
2-s2.0-85117166101
Rights Holder(s)
Scopus
Bibliographic Citation
Journal of the Medical Association of Thailand. Vol 104, No.10 (2021)
Suggested Citation
Pitakchotiwan P., Linasmita P., Buppanharun J., Upapan P., Wanthong N., Tantisiriwat W. 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. Journal of the Medical Association of Thailand. Vol 104, No.10 (2021). doi:10.35755/jmedassocthai.2021.10.13128 Retrieved from: https://hdl.handle.net/20.500.14740/8170
Abstract
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. © JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND | 2021.
Subject(s)
Abacavir
HLA B57 antigen
Tenofovir
Abdominal pain
Allele
Allergic reaction
Article
CD4 lymphocyte count
Cost effectiveness analysis
Drug efficacy
Gene frequency
Genotype
Human
Human immunodeficiency virus infection
Hyperlipidemia
Hypersensitivity
Kidney failure
Liver toxicity
Lymphocytopenia
Myalgia
Nephrotoxicity
Pharyngitis
Prescription
Prevalence
Root cause analysis
Spirometry
Substitution reaction
Sustained virologic response
Thorax radiography
Virus load
HLA B57 antigen
Tenofovir
Abdominal pain
Allele
Allergic reaction
Article
CD4 lymphocyte count
Cost effectiveness analysis
Drug efficacy
Gene frequency
Genotype
Human
Human immunodeficiency virus infection
Hyperlipidemia
Hypersensitivity
Kidney failure
Liver toxicity
Lymphocytopenia
Myalgia
Nephrotoxicity
Pharyngitis
Prescription
Prevalence
Root cause analysis
Spirometry
Substitution reaction
Sustained virologic response
Thorax radiography
Virus load