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PLoS Negl Trop Dis ; 14(10): e0008746, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33064728

RESUMEN

Leprosy is a stigmatizing, chronic infection which degenerates the nervous system and often leads to incapacitation. Multi-drug therapy which consists of dapsone, rifampicin and clofazimine has been effective to combat this disease. In Indonesia, especially in Papua Island, leprosy is still a problem. Furthermore, there had been higher reports of Dapsone Hypersensitivity Syndrome (DHS) which also challenges leprosy elimination in certain aspects. Globally, DHS has a prevalence rate of 1.4% and a fatality rate up to 13%. The aim of this study is to validate HLA-B*13:01, a previously discovered biomarker for DHS in the Chinese population, as a biomarker for DHS in the Papua population.This is a case-control study of 34 leprosy patients who presented themselves with DHS (case subjects) and 52 leprosy patients without DHS (control subjects). Patients were recruited from 2 provinces: Papua and West Papua. DNA was extracted from 3 ml blood specimens. HLA-B alleles were typed using the gold-standard sequence based typing method. Results were then analysed using logistic regression and risk assessment was carried out. The results of HLA-typing showed that HLA-B*13:01 was the most significant allele associated with DHS, with odds ratio = 233.64 and P-value = 7.11×10-9, confirming the strong association of HLA-B*13:01 to DHS in the Papua population. The sensitivity of this biomarker is 91.2% and specificity is 96.2%, with an area under the curve of 0.95. HLA-B*13:01 is validated as a biomarker for DHS in leprosy patients in Papua, Indonesia, and can potentially be a good predictor of DHS to help prevent this condition in the future.


Asunto(s)
Dapsona/efectos adversos , Hipersensibilidad a las Drogas/prevención & control , Antígeno HLA-B13/genética , Leprostáticos/efectos adversos , Lepra/tratamiento farmacológico , Adolescente , Adulto , Alelos , Biomarcadores , Estudios de Casos y Controles , Clofazimina/administración & dosificación , Dapsona/administración & dosificación , Hipersensibilidad a las Drogas/epidemiología , Quimioterapia Combinada , Femenino , Humanos , Indonesia , Leprostáticos/administración & dosificación , Modelos Logísticos , Masculino , Rifampin/administración & dosificación , Medición de Riesgo , Síndrome , Adulto Joven
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