TY - JOUR
T1 - HLA-B∗58:01 carrier status of Hmong in Minnesota
T2 - First in Hmong genotyping for prevalence of this biomarker of risk for severe cutaneous adverse reactions caused by allopurinol
AU - Peng, Kerui
AU - Bjork, Jonathan
AU - Wen, Ya Feng
AU - Roman, Youssef M.
AU - Culhane-Pera, Kathleen
AU - Lo, May Xia
AU - Gertner, Elie
AU - Straka, Robert J.
N1 - Publisher Copyright:
Copyright © 2020 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
PY - 2020/2/1
Y1 - 2020/2/1
N2 - Allopurinol, a common medication to treat gout, is associated with severe cutaneous adverse reactions, and the occurrence is highly predicted by an individual's HLA-B∗58:01 carrier status. Guidelines endorse preemptive testing in select Asian populations before initiating allopurinol. The Hmong, an Asian subpopulation originally from China who now live dispersed around the world, have a 2.5-fold higher risk of gout when compared to non-Hmong in Minnesota. Given the concern for severe cutaneous adverse reactions when prescribing allopurinol, we quantified the carrier status of HLA-B∗58:01 in Hmong from two independent cohorts in Minnesota. Using a community-based participatory research approach, HLA-B∗58:01 carrier status was determined in 49 US-born Hmong without a history of gout or allopurinol use. Further, 47 Hmong patients undergoing clinical evaluation to receive gout pharmacotherapy were also tested. The frequency of HLA-B∗58:01 positive carrier status in these two cohorts were compared to published data from a Han Chinese (n = 2910) and a Korean cohort (n = 485) using a Fisher's exact test with a Bonferroni-corrected P-value <0.025 for significance. With one uninterpretable result, we identified two out of 95 people (2.1%) who carried HLA-B∗58:01. This 2.1% incidence in these Hmong adults is notably lower than Han Chinese (19.6%, P < 0.0001) and Korean (12.2%, P = 0.0016) populations. Though commonly understood to be of Chinese descent, the lower prevalence within the Hmong underscores the risk of generalizing genotypic findings from Chinese to Asian subpopulations. We suggest no change to the current guidelines recommending which populations should be tested for HLA-B∗58:01 before allopurinol use until further validation.
AB - Allopurinol, a common medication to treat gout, is associated with severe cutaneous adverse reactions, and the occurrence is highly predicted by an individual's HLA-B∗58:01 carrier status. Guidelines endorse preemptive testing in select Asian populations before initiating allopurinol. The Hmong, an Asian subpopulation originally from China who now live dispersed around the world, have a 2.5-fold higher risk of gout when compared to non-Hmong in Minnesota. Given the concern for severe cutaneous adverse reactions when prescribing allopurinol, we quantified the carrier status of HLA-B∗58:01 in Hmong from two independent cohorts in Minnesota. Using a community-based participatory research approach, HLA-B∗58:01 carrier status was determined in 49 US-born Hmong without a history of gout or allopurinol use. Further, 47 Hmong patients undergoing clinical evaluation to receive gout pharmacotherapy were also tested. The frequency of HLA-B∗58:01 positive carrier status in these two cohorts were compared to published data from a Han Chinese (n = 2910) and a Korean cohort (n = 485) using a Fisher's exact test with a Bonferroni-corrected P-value <0.025 for significance. With one uninterpretable result, we identified two out of 95 people (2.1%) who carried HLA-B∗58:01. This 2.1% incidence in these Hmong adults is notably lower than Han Chinese (19.6%, P < 0.0001) and Korean (12.2%, P = 0.0016) populations. Though commonly understood to be of Chinese descent, the lower prevalence within the Hmong underscores the risk of generalizing genotypic findings from Chinese to Asian subpopulations. We suggest no change to the current guidelines recommending which populations should be tested for HLA-B∗58:01 before allopurinol use until further validation.
KW - 58:01'
KW - HLA-B
KW - allopurinol
KW - gout
KW - pharmacogenetics
KW - severe cutaneous adverse reactions
UR - http://www.scopus.com/inward/record.url?scp=85077221685&partnerID=8YFLogxK
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U2 - 10.1097/FPC.0000000000000391
DO - 10.1097/FPC.0000000000000391
M3 - Article
C2 - 31658186
AN - SCOPUS:85077221685
SN - 1744-6872
SP - 21
EP - 25
JO - Pharmacogenetics and genomics
JF - Pharmacogenetics and genomics
ER -