Association of HLA-B*35 and moderate or severe cutaneous reactions secondary to benznidazole treatment in chronic chagas disease.
Por:
Bosch-Nicolau P, Salvador F, Sánchez-Montalvá A, Franco-Jarava C, Arrese-Muñoz I, Sulleiro E, Roure S, Valerio L, Oliveira-Souto I, Serre-Delcor N, Pou D, Treviño B, Aznar ML, Espinosa-Pereiro J and Molina I
Publicada:
1 jun 2022
Ahead of Print:
1 dic 2021
Resumen:
OBJECTIVES: Benznidazole is the first-line treatment for Chagas disease. Adverse events appear in more than 50% of patients, leading to discontinuation in approximately 15%. Cutaneous reactions are one of the most frequent adverse events. Human leucocyte antigen (HLA) genotyping studies identified an association between cutaneous reactions to benznidazole and carrying the specific allele HLA-B*35:05. We designed the present study to prospectively confirm this association. METHODS: This is a prospective observational study including Chagas disease patients aged 18 years or more who accepted to receive benznidazole treatment following current guidelines. Allele genotyping of HLA-B was determined in all patients. Clinical and analytical follow up was performed at days 0, 7, 14, 30 and 60 of treatment. RESULTS: Two-hundred and seven individuals were included. Seventy per cent were female with a mean age of 45.1 (SD ± 9.86) years mainly from Bolivia (92.8%). In 102 (49.3%) cases a cutaneous reaction was diagnosed. Forty-eight (46.6%) were classified as mild, 37 (35.9%) as moderate and 18 (17.5%) as severe. Thirty-two (15.4%) patients had to definitively interrupt the treatment because of a cutaneous reaction. Female sex (OR 4.49; 95% CI 1.62-12.47), new-onset eosinophilia before cutaneous symptoms (OR 2.55; 95% CI 1.2-5.43) and carrying the HLA-B*35 allelic group (OR 2.58; 95% CI 1.2-5.51) were all predictors of moderate to severe cutaneous reactions. No statistical significance was found when the specific allele HLA-B*35:05 was analysed. CONCLUSIONS: Patients carrying the HLA-B*35 allelic group are at higher risk of moderate to severe reactions when taking benznidazole treatment.
Filiaciones:
Bosch-Nicolau P:
Tropical Medicine & International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, PROSICS Barcelona, University Hospital Vall D'Hebron, Barcelona, Spain
Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
Salvador F:
Tropical Medicine & International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, PROSICS Barcelona, University Hospital Vall D'Hebron, Barcelona, Spain
Sánchez-Montalvá A:
Tropical Medicine & International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, PROSICS Barcelona, University Hospital Vall D'Hebron, Barcelona, Spain
Franco-Jarava C:
Immunology Department, University Hospital Vall D'Hebron, Barcelona, Spain
Arrese-Muñoz I:
Immunology Department, University Hospital Vall D'Hebron, Barcelona, Spain
Sulleiro E:
Microbiology Department, University Hospital Vall D'Hebron, Barcelona, Spain
:
North Metropolitan International Health Unit, PROSICS Metropolitana Nord, Badalona, Spain
Infectious Diseases Department, Germans Trias I Pujol University Hospital, Badalona, Spain
Valerio L:
North Metropolitan International Health Unit, PROSICS Metropolitana Nord, Badalona, Spain
Oliveira-Souto I:
Tropical Medicine & International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, PROSICS Barcelona, University Hospital Vall D'Hebron, Barcelona, Spain
Serre-Delcor N:
Tropical Medicine & International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, PROSICS Barcelona, University Hospital Vall D'Hebron, Barcelona, Spain
Pou D:
Tropical Medicine & International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, PROSICS Barcelona, University Hospital Vall D'Hebron, Barcelona, Spain
Treviño B:
Tropical Medicine & International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, PROSICS Barcelona, University Hospital Vall D'Hebron, Barcelona, Spain
Aznar ML:
Tropical Medicine & International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, PROSICS Barcelona, University Hospital Vall D'Hebron, Barcelona, Spain
Espinosa-Pereiro J:
Tropical Medicine & International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, PROSICS Barcelona, University Hospital Vall D'Hebron, Barcelona, Spain
Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
Molina I:
Tropical Medicine & International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, PROSICS Barcelona, University Hospital Vall D'Hebron, Barcelona, Spain
Medicine Department, Universitat Autònoma de Barcelona, Barcelona, Spain
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