Utility evaluation of HLA-B*13:01 screening in preventing trichloroethylene-induced hypersensitivity syndrome in a prospective cohort study.
Occup Environ Med
; 77(3): 201-206, 2020 03.
Article
em En
| MEDLINE
| ID: mdl-32024660
ABSTRACT
OBJECTIVES:
Trichloroethylene (TCE) -induced hypersensitivity syndrome (TIHS) is a potentially life-threatening disease. Several genetic susceptibility biomarkers have been found to be associated with TIHS, and this systematic prospective study has been conducted to evaluate the utility of these genetic susceptibility biomarkers in preventing the disease.METHODS:
The newly hired TCE-exposed workers were recruited from March 2009 to October 2010. HLA-B*1301 genotyping and 3-month follow-up procedure were conducted. All workers were monitored for adverse reaction by telephone interview every week. The workers with early symptoms of TIHS were asked to go to the hospital immediately for further examination, diagnosis and treatment. The medical expense record data of patients with TIHS were collected for cost-effectiveness analysis in 2018.RESULTS:
Among 1651 workers, 158 (9.57%) were found to carry the HLA-B*1301 allele and 16 (0.97%) were diagnosed with TIHS. HLA-B*1301 allele was significantly associated with an increased TIHS risk (relative risk=28.4, 95% CI 9.2 to 86.8). As a risk predictor of TIHS, HLA-B*1301 testing had a sensitivity of 75%, a specificity of 91.1% and an area under curve of 0.83 (95% CI 0.705 to 0.955), the positive and negative predictive values were 7.6% and 99.7%, respectively. The incidence of TIHS was significantly decreased in HLA-B*1301 non-carriers (0.27%) compared with all workers (0.97%, p=0.014). Cost-effectiveness analysis showed that HLA-B*1301 screening could produce an economic saving of $4604 per TIHS avoided.CONCLUSIONS:
Prospective HLA-B*1301 screening may significantly reduce the incidence of TIHS and could be a cost effective option for preventing the disease in TCE-exposed workers.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Tricloroetileno
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Antígenos HLA-B
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Exposição Ocupacional
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Dermatite
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Hipersensibilidade a Drogas
Tipo de estudo:
Diagnostic_studies
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Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Screening_studies
Limite:
Adult
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Female
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Humans
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Male
País como assunto:
Asia
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article