Association of HLA genotypes with Beta-lactam antibiotic hypersensitivity in children (2021)

Title           : Association of HLA genotypes with Beta-lactam antibiotic hypersensitivity in children

Researcher       : Clin.Prof.Suwat Benjaponpitak 

Department     : Faculty of Medicine, Siam University, Bangkok, Thailand

E-mail                : med@siam.edu

Abstract            : Background: Beta-lactam (BL) antibiotics hypersensitivity is common in children. Clinical manifestation of BL hypersensitivity varies from mild to severe cutaneous adverse drug reactions (SCARs).

Objective: To determine the association of HLA genotype and BL hypersensitivity and the prevalence of true drug allergy in patients with history of BL hypersensitivity.

Methods: A case-control study was performed in 117 children with aged 1-18 years. Children with history of non-SCARs BL hypersensitivity were evaluated for true drug hypersensitivity including skin test and drug provocation test. Tolerant control patients were children who could tolerate BL for at least 7 days without hypersensitivity reaction. HLA genotype (HLA-A, HLA-B, HLA-C and HLA-DRB1) were performed in 24 cases and 93 tolerant controls using PCR-SSO (polymerase chain reaction – sequence specific oligonucleotide probes).

Results: There were association of HLA-C*04:06 (OR = 13.14, 95%CI: 1.3-137.71; p = 0.027), and HLA-C*08:01 (OR = 4.83, 95%CI: 1.93-16.70; p = 0.016) with BL hypersensitivity. HLA-B*48:01 was strongly associated with immediate reaction from BL hypersensitivity (OR = 37.4, 95%CI: 1.69-824.59; p = 0.016) while HLA-C*04:06, HLA-C*08:01 and HLA-DRB1*04:06 were associated with delayed reaction (p < 0.05). Among 71 cases who were newly evaluated for BL hypersensitivity, only 7 cases (9.8%) had true BL hypersensitivity.

Conclusions: Less than 10% of children with suspected of BL hypersensitivity have true hypersensitivity. There might be a role of HLA-B, HLA-C and HLA-DRB1 genotype in predicting BL hypersensitivity in Thai children.

Link to Academic article:  Asian Pacific Journal of Allergy and Immunology, 2021, 39(3), pp. 197–205. DOI: 10.12932/AP-271118-0449

Journal : Asian Pacific journal of allergy and immunology / in Scopus

Citation : Singvijarn, P., Manuyakorn, W., Mahasirimongkol, S., Wattanapokayakit, S., Inunchot, W., Wichukchinda, N., Suvichapanich, S., Kamchaisatian, W., & Benjaponpitak, S. (2021). Association of HLA genotypes with Beta-lactam antibiotic hypersensitivity in children. Asian Pac J Allergy Immunol. 39(3), 197–205. doi: 10.12932/AP-271118-0449. Epub ahead of print. PMID: 31012593.