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Association of HLA-B∗35 and moderate or severe cutaneous reactions secondary to benznidazole treatment in chronic chagas disease.

Authors
  • Bosch-Nicolau, Pau1
  • Salvador, Fernando2
  • Sánchez-Montalvá, Adrián2
  • Franco-Jarava, Clara3
  • Arrese-Muñoz, Iria3
  • Sulleiro, Elena4
  • Roure, Silvia5
  • Valerio, Lluis6
  • Oliveira-Souto, Inés2
  • Serre-Delcor, Núria2
  • Pou, Diana2
  • Treviño, Begoña2
  • Aznar, María L2
  • Espinosa-Pereiro, Juan7
  • Molina, Israel8
  • 1 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. Electronic address: [email protected] , (Spain)
  • 2 Tropical Medicine & International Health Unit Vall D'Hebron-Drassanes, Infectious Diseases Department, PROSICS Barcelona, University Hospital Vall D'Hebron, Barcelona, Spain. , (Spain)
  • 3 Immunology Department, University Hospital Vall D'Hebron, Barcelona, Spain. , (Spain)
  • 4 Microbiology Department, University Hospital Vall D'Hebron, Barcelona, Spain. , (Spain)
  • 5 North Metropolitan International Health Unit, PROSICS Metropolitana Nord, Badalona, Spain; Infectious Diseases Department, Germans Trias I Pujol University Hospital, Badalona, Spain. , (Spain)
  • 6 North Metropolitan International Health Unit, PROSICS Metropolitana Nord, Badalona, Spain. , (Spain)
  • 7 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. , (Spain)
  • 8 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. Electronic address: [email protected] , (Spain)
Type
Published Article
Journal
Clinical Microbiology and Infection
Publisher
Elsevier
Publication Date
Jun 01, 2022
Volume
28
Issue
6
Identifiers
DOI: 10.1016/j.cmi.2021.11.021
PMID: 34863919
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

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. 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. 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. Patients carrying the HLA-B∗35 allelic group are at higher risk of moderate to severe reactions when taking benznidazole treatment. Copyright © 2021 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

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