A patient develops Stevens-Johnson syndrome (SJS) after starting carbamazepine. The HLA allele most strongly associated with carbamazepine-induced SJS in South and Southeast Asian populations is:

• A HLA-B*57:01 (associated with abacavir hypersensitivity)
• B HLA-B*58:01 (associated with allopurinol-SJS/TEN in Asian populations)
• C HLA-A*31:01 (associated with carbamazepine-DRESS in Caucasians and Japanese)
• D HLA-B*15:02 (strongly associated with carbamazepine-SJS/TEN in Han Chinese, Thai, Malaysian) ✓

Explanation

HLA-B*15:02 has near-complete association (odds ratio >100) with carbamazepine-induced SJS/TEN in Han Chinese, Thai, and Malaysian patients. Screening for HLA-B*15:02 before initiating carbamazepine is recommended (and mandatory in Taiwan) in these populations. HLA-B*57:01 screening is required before abacavir; HLA-B*58:01 before allopurinol in Asian patients; HLA-A*31:01 is associated with carbamazepine-DRESS predominantly in Caucasian and Japanese patients. These pharmacogenomic tests prevent severe cutaneous adverse drug reactions.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.