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Detection of abacavir hypersensitivity by ELISpot method.

Stefan Esser1, Robert Jablonka, Falko M Heinemann

  • 1HIV/STD-Out Patient Clinic, Department of Dermatology and Venerology, University Hospital Essen, Essen, Germany.

Inflammation & Allergy Drug Targets
|February 18, 2012
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Summary

A new ELISpot test can detect abacavir hypersensitivity reactions (HSR) in HIV patients. A negative abacavir-ELISpot result strongly suggests the absence of abacavir-HSR, aiding treatment decisions.

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The Isolation, Differentiation, and Quantification of Human Antibody-secreting B Cells from Blood: ELISpot as a Functional Readout of Humoral Immunity

Published on: December 14, 2016

Area of Science:

  • Immunology
  • Pharmacology
  • Infectious Diseases

Background:

  • Abacavir hypersensitivity reaction (HSR) is a significant concern in HIV treatment.
  • While HLA-B*57:01 predicts abacavir-HSR in Caucasians, reactions also occur in negative patients.
  • Distinguishing abacavir-HSR from other adverse drug reactions is crucial for HLA-B*57:01 negative individuals.

Purpose of the Study:

  • To evaluate the abacavir-ELISpot assay as a diagnostic tool for abacavir-HSR.
  • To assess the utility of abacavir-ELISpot in differentiating abacavir-HSR from other adverse reactions in HIV patients.
  • To establish a reliable method for identifying patients experiencing abacavir-HSR.

Main Methods:

  • Peripheral blood mononuclear cells (PBMCs) from 87 HIV patients were analyzed.
  • PBMCs were stimulated with abacavir.
  • Interferon-gamma production was measured using the ELISpot assay.

Main Results:

  • Patients with confirmed or suspected abacavir-HSR showed significantly higher numbers of abacavir-specific cells compared to those without HSR.
  • Abacavir-specific cell counts were 82.3±23.0 and 10.5±4.5 spot forming cells per million PBMCs in confirmed and suspected HSR groups, respectively (p < .005).
  • Patients without HSR had -0.5±1.0 spot forming cells per million PBMCs (p < .005).

Conclusions:

  • The abacavir-specific ELISpot assay was successfully established.
  • Preliminary data suggest that a negative abacavir-ELISpot result nearly excludes abacavir-HSR.
  • The ELISpot assay may aid clinicians in deciding whether to continue or withdraw abacavir treatment.