| Backgroud:HLA-B* 5701 is the class I allele most consistently associated with control and treatment of human immunodeficiency virus class I (HIV-1) infection.Abacavir is a nucleoside analogue inhibitor for the treatment of HIV-1 infection. Drug hypersensitivity, which represents the major treatment-limiting toxicity for abacavir use, occurs in approximately 5-8% of recipients within six weeks of commencing therapy. There is a strong association between carriage of HLA-B*5701 and abacavir hypersensitivity reactions which had been confirmed by many studies.In prospective Randomized Evaluation of DNA Screening in a Clinical Trial(PREDICT), 100% of patients who were immunologically confirmed by epicutaneous patch testing carry the HLA-B* 5701 allele. In order to avoid the ABC HSR,the United States and other Western countries have requested screening for HLA-B* 5701 befor starting patients on an abacavir-containing regimen.The important association between HLA-B* 5701 and HIV should arouse our attention, Some foreign researches shows that the prevalence and abacavir drug toxicity were different in different races.So far only few research about ABC and HLA-B* 5701 in China, There is not much data about the prevalence of HLA-B* 5701 in China.Objective:To study the prevalence of HLA-B* 5701 in HIV patients of Intravenous Drug Users (IDUs) in Sichuan Liangshan and the Han population man have sex with man in 9 places of China; Compare to the data between the Yi nationality and the han nationality; Compare to the data of domestic and foreign researches.Methods:1. Collected 1856 blood-EDTA samples of HIV patients of Intravenous Drug Users (IDUs) in Sichuan Liangshan and the Han population man have sex with man in 9 places(Xining, Huhehaote, Nanjing, Changchun, Jingzhou, Haikou, Hebei, Mudanjiang, Taiyuan)of China, isolated plasma and blood cells,extracted genomic DNA from blood cells. 2. HLA-B*5701 screening was performed with the use of multiplexed sequence specific primers PCR(SSP-PCR) method, read the results by agarose gel electrophoresis.3. With additional DNA sequencing for simples for which the agarose gel electrophoresis results were positive, DNA sequencing were done by BEIJIN BO FU RUI GENE DIAGNOSTICS LTD.4. using SAS 9.1 software for statistical analysis.Results:1. this study involved 1856 samples, including 813 samples of Yi population in Liangshan who were infected with human immunodeficiency virus type 1 by using Intravenous drug and 1043 samples of Han population (the man have sex with man collecting from 9 places of China and Han population in Liangshan who were infected with human immunodeficiency virus type 1 by using Intravenous drug), there are 2 cases HLA-B* 5701-positive in Yi IDUs(0.246%) and 34 cases in Han population(3.26%).Accoding the statistical analysis of two populations,χ2=21.8180,p<0.0001,the prevalence of HLA-B*5701 in Han populations of China was higher than the Yi populaition's in Liangshan.2.5 of 1043 Liangshan IDUs(Yi and Han population) who infected HIV carrying HLA-B* 5701 allele, the prevalence was 0.479%.3 of 230 Han patients carrying HLA-B* 5701 allele (1.30%); 2 (both are male)of 813 Yi population carrying HLA-B* 5701 allele (0.246%). Fisher exact probability was p=0.0740, There was no significant statistical difference between Yi and Han populations who infected HIV by IDUS in Liangshan about the prevenlence of HLA-B* 5701.3. There are 31 HLA-B*5701 positive samples in the Han-based HIV-uninfected MSM population, the prevalence of HLA-B*5701 was 3.81%. the number of HLA-B* 5701 positive cases in Xining (6 cases) and Hohhot (7cases) was the top two of 9 places in this study. There was no HLA-B*5701 positive samples in Mudanjiang and Haikou. the prevalence of Xi'ning and huhehaote was 8.72% (13/149), the prevalence of the other 7 palces except for Xining and Huhhot as a whole was 2.71%(18/672), theχ2 test result wasχ2=13.7114, p=0.00002, p<0.05, the prevalence of HLA-B* 5701 of Xining and Huhhot was higher than the other 7 places as a whole.4. Compared to Liangshan IDUs, There was no significant statistical difference of the prevalence of HLA-B* 5701 between Han population of Liangshan IDUs and the 9 places of Han MSM. the prevalence of HLA-B* 5701 of the 7 places of MSM was higher than the Yi population of Liangshan IDUs.5. The Han population man have sex with man in 9 places of China and the Han IDUs of Liangshan can be divided into southern population which including Nanjing, Jingzhou, Haikou,Han IDUs in Liangshan and northern populations which including Huhhot, Taiyuan, Changchun, Hebei, Xining and Mudanjiang. The prevalence of HLA-B* 5701 in southern population was 1.73%(9/519), and in nortnern population was 4.78%(25/524),The statistical result wasχ2=7.6255, p=0.0058 of the two populations, So the prevalence of HLA-B* 5701 of southern population is lower than the northern population's in this study. If the northern population only involved Taiyuan, Changchun, Hebei, Mudanjiang,then the prevalence was 3.2%(12/375). The statistical result isχ2=2.0394, p=0.1533, p>0.05. So there was no siginificant statistical difference between the southern population and the northern population's about the prevenlence of HLA-B* 5701 in this study.6. In this study, we did not found other HLA-B* 5701 subtypes useing SSP-PCR method.Conclusions:1. the prevalence of HLA-B* 5701 in HIV patients among Yi IDUs in Liangshan was lower than the black population and white population compared to the foreign research data, and also lower than the Han population of China in this study. There was no significant statistical difference between the Han population of China and the black population about the prevenlence of HLA-B* 5701,and the HLA-B* 5701 positive rate of Han population was lower than the white population's.2. We suggest that the abcavir shoud not be used in Xining and huhehaote before further experiments, if have to, the patient should accept HLA-B*5701 screening before starting abacavir-containing regimen.3. HLA-B*5701 screening should be taken before starting abacavir-containing regimen if abacavir was been applied in Han population in some places of China.4. Abacavir could be used for HIV treatment in Sichuan Liangshan without HLA-B*5701 screening because of low prevalence of HLA-B*5701. |
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