External quality assessment of HLA-B*5701 reporting: an international multicentre surveyEmma Hammond, Coral-Ann Almeida, Cyril Mamotte, David Nolan, Elizabeth Phillips, Tineke Asma Schollaardt, M John Gill, Jonathan B Angel, Doris Neurath, Jianping Li, Tony Giulivi, Cathy McIntyre, Galina Koultchitski, Betty Wong, Marciano Reis, Anita Rachlis, David E Cole, Choo Beng Chew, Stefan Neifer, Richard Lalonde, Michel Roger, Annie Jeanneau, Simon Mallal
Corresponding author name: Emma Hammond
Corresponding author e-mail: E.Hammond@murdoch.edu.au
Citation: Antiviral Therapy 2007; 12:1027-1032
Objectives: HLA-B*5701 strongly predicts abacavir hypersensitivity (HSR), but implementation of effective routine screening into clinical practice requires testing be practical and accurate. We tested the proficiency of HLA-B*5701 typing among laboratories using sequencespecific primer PCR.
Design and methods: DNA panels (1 and 2) were distributed to seven laboratories (A to G) for blinded typing of the HLA-B*5701 allele. Panel 1 (n=10 samples; n=7 laboratories) included 3 positives and other closely related B17 subtypes (B*5702, B*5703, B*5704 and B*5801). Panel 2 (n=96 samples; n=4 laboratories) included 36 positives among a broad spectrum of other B alleles. Two laboratories (A and B) also submitted 96 routine samples, typed by the same methodology, to the reference centre for additional analysis by sequence-based typing.
Results: All laboratories correctly typed panel 1 for HLA-B*5701 carriage. Laboratories A, B and C identified HLA-B*5701 alleles in panel 2 with 100% sensitivity and 100% specificity. Laboratory D reported one false negative, reportedly due to a sampling error. The results obtained for routine samples typed by laboratories A and B and those generated by the reference laboratory using sequencing were fully concordant.
Conclusions: Detection of HLA-B*5701 alleles among laboratories was 100% specific and 99.4% sensitive, indicating that participating HIV testing laboratories were currently offering effective primary screening to identify individuals at high risk of abacavir HSR. Accurate reporting of HLA-B*5701 status is critical for the safe administration of this drug and participation in quality assurance programmes by all sites who report HLA-B*5701 status should be promoted.