HLA-B∗ 1502 is associated with carbamazepine induced Stevens-Johnson syndrome in North Indian population

Abstract

The evidence of association between HLA-B(∗)1502 and anticonvulsant induced Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) from the Indian population is scant. Patients with a history of SJS/TEN secondary to carbamazepine or phenytoin were enrolled. The control group comprised of patients who had received carbamazepine/phenytoin for ⩾ 6 months without any adverse cutaneous event. Low-resolution DNA typing for HLA-B and high resolution HLA-B(∗)15 typing was performed. Seventeen patients with history of SJS/TEN secondary to carbamazepine (9) or phenytoin (8) and 50 tolerant controls (carbamazepine-37; phenytoin-13) were enrolled. The mean age of patients and controls was 33.9 ± 11.6 and 28.1 ± 9.9 years, respectively. HLA-B(∗)1502 was observed in 2/9 (22.2%) carbamazepine-SJS/TEN patients and none of the 37 carbamazepine tolerant controls (p = 0.035). HLA-B(∗)1502 was not observed in any of the 8 phenytoin-SJS/TEN patients or the 13 phenytoin tolerant controls. Our data suggests that HLA-B(∗)1502 is a risk factor for carbamazepine induced SJS/TEN. Therefore, HLA-B(∗)1502 testing should be performed prior to initiating carbamazepine in North Indian population.

Keywords: HLA; India; PCR; Pharmacogenetics; Toxic epidermal necrolysis.