HLA-B*5801 and cutaneous reactions to allopurinol in the Kinh population of Ho Chi Minh City (Vietnam)

The aim of this prospective study was to investigate risk factors, including HLA-B*5801, for mild (MCAR) and severe (SCAR) cutaneous reactions in the predominant Kinh ethnicity of Vietnam. Ten SCAR patients (toxic necrotic epidermolysis (TEN) and/or Stevens Johnson syndromes) were recruited from hospital-based dermatology departments in Ho Chi Minh City (HCMC), 54 patients with MCARs from the same departments and from the Vien Gut medical center at HCMC, that is specialized in gout care, and 112 tolerant gouty patients (no skin reaction after at least 3 months from the last increment in allopurinol dose) at the Vien Gut. Clinical data were prospectively collected and HLA-B*5801 typing was done using PG5801 DNA detection kit (Pharmigene-Taiwan) according to manufacturer instruction. HLA*135801 was present in the 10 TEN/Stevens Johnson patients and was significantly associated with SCARs (P < 0.0001, OR 171; 95 % CI: 20; 7889). Other known factors such as female sex, non-gout, renal failure, hypertension, dyslipemia, lack of allopurinol titration, but not allopurinol dose were associated with SCARs. The only associations with MCARs were lack of allopurinol titration, hypertension and dyslipemia. (C) 2019 Published by Elsevier Masson SAS on behalf of l'Academie nationale de medecine.