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Necessity of a human leukocyte antigen-B*58: 01 screening test for preventing severe cutaneous adverse reactions.

First, severe cutaneous adverse reactions (SCARs) are relatively infrequent events, in which, in many cases, the underlying drug cause is never clarified. However, several associations of human leukocyte antigens (HLAs) with these pathologies have been reported recently. In the specific case of allopurinol, we must point out that, although it had initially been described in highly circumscribed Asian populations [2], several cases have been described in patients without oriental ancestors [3]. In White patients, the reported approximate HLA B*58:01 allele frequency is less than 1%. This last aspect may be influenced by the fact that HLA B*58:01 determination is not carried out routinely in clinical practice, at least in Europe and North America. In addition, in USA, the determination of this HLA has recently been considered as non cost-efective for the prevention of SCADRs in White and Afro-American populations [4].