Evidence map›Paper›PMID 40829703›Full record

ArticleClinical biochemistry2025

Gaps in guideline adherence: evaluating HLA-B*57:01 screening for abacavir sensitivity and the implementation of evidence-based HIV care.

Lisa V Kalman, Yang Xia, Ya-Lin A Huang, Kate Buchacz, Rex Astles, Jesse O'Shea

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In one paragraph

Article in Clinical biochemistry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Lisa V KalmanDivision of Laboratory Systems, Office of Laboratory Systems and Response, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329, USA. Electronic address: LKalman@cdc.gov.
Yang XiaDivision of Laboratory Systems, Office of Laboratory Systems and Response, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329, USA.
Ya-Lin A HuangDivision of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329, USA.
Kate BuchaczDivision of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329, USA.
Rex AstlesDivision of Laboratory Systems, Office of Laboratory Systems and Response, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329, USA.
Jesse O'SheaDivision of HIV Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Atlanta, GA 30329, USA.

Funding

Intramural CDC HHS CC999999
6 · The paper itself

Abstract

objectiveApproximately 5-8 % of the population carries the HLA-B*57:01 allele, which increases the risk of severe hypersensitivity reactions to abacavir. Current guidelines and an FDA black box warning recommend HLA-B*57:01 screening for all patients before starting abacavir. We assessed the proportion of patients who undergo screening before initiating abacavir to evaluate adherence to guidelines.

designA retrospective cohort study using national IQVIA® PharMetrics Plus reimbursement data.

methodsData from the 2014-2022 IQVIA® PharMetrics Plus March 2023 dataset were analyzed. We identified patients aged ≥ 18 years who were newly prescribed abacavir, with ≥ 12 months of continuous enrollment before their first abacavir prescription. We examined the proportion of individuals who received HLA-B*57:01 screening any time before their initial abacavir prescription and conducted a multivariable logistic regression analysis on the receipt of HLA-B*57:01 screening adjusting for sex, age, year, and region.

resultsWe identified 7,391 patients newly prescribed abacavir between 2014 and 2022. Approximately 46 % received an HLA-B*57:01 screen before initiation of abacavir. Annual screening rates ranged from 44 % to 50 % between 2015 and 2018 and dropped to 17 % by 2022. Screening was less likely to occur after 2018, compared to earlier in the study period, and more likely for younger as well as male patients.

conclusionsThese findings highlight broader challenges in HIV guideline adherence, emphasizing the need for ongoing evaluation and systematic interventions to improve implementation and patient safety.

Indexed as

Anti-HIV AgentsDideoxynucleosidesGuideline AdherenceHIV InfectionsHLA-B AntigensAbacavirAdultCyclopropanesDideoxyadenosineDrug HypersensitivityFemaleHumansMaleMiddle AgedPractice Guidelines as TopicRetrospective StudiesAbacavirAnti-HIV AgentsCyclopropanesDideoxyadenosineDideoxynucleosidesHLA-B*57:01 antigenHLA-B AntigensAbacavirAntiretroviral therapyClinical guidelineHIVHLA-B*57:01 screeningHypersensitivity reaction

Identifiers

PMID40829703
PMCPMC12398405

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