The expanding role of HLA gene tests for predicting drug side effects

Am J Med Sci. 2024 Jan;367(1):14-20. doi: 10.1016/j.amjms.2023.10.004. Epub 2023 Oct 12.

Abstract

Adverse drug reactions can be either dose-dependent (Type A) or idiosyncratic (Type B). Type B adverse drug reactions tend to be extremely rare and difficult to predict. They are usually immune-mediated. Examples include severe skin reactions and drug-induced liver injury. For many commonly prescribed drugs (such as antibiotics), the risk of developing an idiosyncratic adverse drug reaction is influenced by variability in the human leukocyte antigen (HLA) genes. Because these HLA-mediated adverse drug reactions can be lethal, there is growing interest in defining which specific drug-gene relationships might benefit from pre-emptive HLA genotyping and automated clinical decision support. This review summarizes the literature for HLA-mediated adverse reactions linked to common drugs.

Keywords: Adverse drug reaction; Decision support; Pharmacogenetics.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents
  • Chemical and Drug Induced Liver Injury* / etiology
  • Chemical and Drug Induced Liver Injury* / genetics
  • Drug-Related Side Effects and Adverse Reactions* / diagnosis
  • Drug-Related Side Effects and Adverse Reactions* / genetics
  • HLA Antigens / genetics
  • HLA Antigens / pharmacology
  • Humans
  • Skin

Substances

  • HLA Antigens
  • Anti-Bacterial Agents