What causes hypersensitivity to abacavir?

Updated: Dec 07, 2018
  • Author: Ali Torkamani, PhD; Chief Editor: Karl S Roth, MD  more...
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Hypersensitivity to abacavir is immunologically mediated, driven by conventional MHC-I antigen presentation and activation of HLA-B*5701. [4, 5] Activation of HLA-B*5701 restricted CD8+ T cells results in the secretion of the inflammatory mediators TNF-alpha and IFN-gamma and induces the delayed-type hypersensitivity reaction. [4] It is thought that a derivative of the abacavir prodrug binds to an antigen-presenting cleft unique to HLA-B*5701, which explains why the drug does not cause a similar hypersensitivity syndrome in carriers of other HLA-B alleles and why compounds similar to abacavir do not react with HLA-B*5701. [4]

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