Dapsone-induced severe cutaneous adverse drug reactions are strongly linked with HLA-B*13: 01 allele in the Thai population.

ABSTRACT

OBJECTIVES: A previous publication in Chinese leprosy patients showed that the HLA-B*1301 allele is a strong genetic marker for dapsone-induced drug hypersensitivity reactions, however there are no data describing whether HLA-B*1301 is a valid marker for prediction of dapsone-induced drug hypersensitivity reactions in other ethnicities or nonleprosy patients. The aim of this study is to investigate whether there is an association between HLA genotypes and dapsone-induced severe cutaneous adverse reactions (SCARs) in Thai nonleprosy patients. PATIENTS AND METHODS: HLA-B genotypes of 15 patients with dapsone-induced SCARs (11 drug reaction with eosinophilia and systemic symptoms, 4 Stevens-Johnson syndrome/toxic epidermal necrolysis), 29 control patients, and 986 subjects from the general Thai population were determined by the reverse PCR sequence-specific oligonucleotides probe. RESULTS: The HLA-B*1301 allele was significantly associated with dapsone-induced SCARs compared with dapsone-tolerant controls (odds ratio 54.00, 95% confidence interval 7.96-366.16, P=0.0001) and the general population (odds ratio 26.11, 95% confidence interval 7.27-93.75, P=0.0001). In addition, HLA-B*1301 associated with dapsone-induced SJS-TEN (OR 40.50, 95% confidence interval 2.78-591.01, P=0.0070) and DRESS (OR 60.75, 95% confidence interval 7.44-496.18, P=0.0001). CONCLUSION: This study demonstrated an association between HLA-B*1301 and dapsone-induced SCARs including Stevens-Johnson syndrome/toxic epidermal necrolysis and drug reaction with eosinophilia and systemic symptoms in nonleprosy patients. Moreover, these results suggest that the HLA-B*1301 allele may be a useful genetic marker for prediction of dapsone-induced SCARs in Thai and Han-Chinese populations.