Developing pharmacogenetic screening methods for an emergent country: Vietnam

Abstract

Background: The finding of strong associations between certain human leukocyte antigen (HLA) genotypes and the development of severe cutaneous adverse drug reactions (SCARs), such as HLA-B57:01 with abacavir (ABC), HLA-B15:02 with carbamazepine (CBZ), and HLA-B58:01 with allopurinol, has led to the use of HLA screening to prevent SCARs. Screening has been shown to be of great benefit in numerous studies. However, the clinical translation from bench to bedside depends on developing simple, rapid, and cost-effective assays to detect these risk alleles. In highly populated developing countries like Vietnam, where there is a high prevalence of HLA-B15:02 and HLA-B*58:01 correlating with a high incidence of CBZ- and allopurinol-induced SCARs, the availability of suitable assays is crucial for implementing comprehensive screening programs.

Body: We have summarized the role and economic benefits of HLA screening, reviewed published HLA screening methods currently used in pharmacogenetic screening, and examined the advantages and disadvantages of assays developed specifically for use in screening for risk alleles in the prevention of HLA-associated SCARs in Vietnam.

Conclusion: The optimal approach we propose may serve as a template for the development of screening programs in other emerging countries.