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Author Topic: HLA-B5071 testing for Ziagen allergy  (Read 3848 times)

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Offline legolas613

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  • Posts: 20
HLA-B5071 testing for Ziagen allergy
« on: January 09, 2011, 11:59:06 PM »
I was hoping to start my HAART regimen with Epzicom and Intelence. I had to take the HLA-B5071 test to make sure Ziagen was OK for me and it came back positive <possibly allergic>. My question is, what does this mean going forward as I have yet to take any meds and virtually all NRTI's and NNRTI's have rash/hypersensitivity as an adverse effect? I have no known animal/plant/food/drug allergies but I do have KP <genetic skin blotches, severe on my back> body freckles and rozatia, however I have never been tested personally and plan on changing that and getting the good old scratch test. Within my family there is a good deal of food, plant or animal allergies and skin sensitivities (kp, rozatia,eczema) from parents and siblings. Maybe I'm worrying about this too much but what I want to know is, Will this increase my chances for having these rash/hypersensitive reactions to these other drugs in these two classes of HIV meds? I appreciate any response with any medical knowledge in this area or who has had the experience of being allergic to Ziagen and their experiences with other NRTI and NNRTI's taken.
« Last Edit: January 10, 2011, 12:05:31 AM by legolas613 »
2009 Oct -- infected.
2009 Nov -- seroconverted.
2010 Feb -- tested HIV+. 
2010 Feb -- CD4=457,33% VL/WBC=3.8k/4.4
2010 Dec -- CD4=568,40% VL/WBC=3.6k/3.7
2011 Jan -- HLA B5071 test +; couldn't use Ziagen.
2011 Jan -- began Viread, Epivir and Intellence.
2011 May -- CD4=409,43% VL/WBC=UD/3.8
2011 Aug -- CD4=404,44% VL/WBC=8.8k/4.0
2011 Sept -- switched to Truvada & boosted Prezista. CD4 suppression, SE and adherance issues.
2011 Nov -- CD4=522,49% VL/WBC=2.3k/3.5
2012 Jan -- discontinued meds. SE and adherance issues, deciding on new regimen.
2012 Feb -- resistance testing revealed mutations: 3 NRTI (incl K65R), 4 NNRTI and 3 PI's.
2012 Apr -- CD4=599,41% VL/WBC=263/3.8
2012 May -- Shingles
2012 Oct -- CD4=493,36% VL/WBC=4.7k/4.4 (still my latest Dr. visit as of 2/01/2014)

Offline eric48

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Re: HLA-B5071 testing for Ziagen allergy
« Reply #1 on: January 10, 2011, 06:54:36 PM »
Hi,

I have posted a good number of info in Epzicom (aka Kivexa) here:

http://forums.poz.com/index.php?topic=33062.0

you will find some reference, as I think I did discuss it somewhere. On the top of my mind I most likely have cited one article that provides the results of the study and again, as far as I remember, the occurrence allergic reaction to Abacavir (which is a very serious condition) went down from 5% to 1 % after the test was enforced (and out of this 1%, half were individuals with other liver issues ...).

If the outcome of the test is favorable the odds that you are to develop the allergic hypersensitivity reaction is extremely low.

otherwise, the risk exists... depends how you look at a 5 % risk... it is also a 95 % no risk...

Not everyone reacts the same. It is still a strong medication and requires a while to get adjusted (I consider myself as fully adjusted now)

Allergy to one med can not be predicted by your general allergy profile, only the HLA-B5071 test is relevant to Abacavir. and it is relevant to Abacavir ONLY (although I read somewhere it may have a weaker relevance to Nevirapine rash)

The most common alternative to Epzicom is Truvada.

If you (and your doctor) decide to go with Epzicom nonetheless, please make sure to be monitored closely, be at your doctor immediate disposal (forget about that trip to the other side of the globe for the time being ;-)  and be ready.

Have a plan B ready and at hand

Shit happens.

Not always.

Cheers

Eric
« Last Edit: January 10, 2011, 06:57:02 PM by eric48 »
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 2 months

Offline newt

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  • the one and original newt
Re: HLA-B5071 testing for Ziagen allergy
« Reply #2 on: January 10, 2011, 07:28:14 PM »
To be accurate and concise, the HLA test for abacavir allergy is robust and suggests it is highly likely (more than 95% likely) that you will have a dangerous allergic reaction if you take abacavir (brand name Ziagen, also one of the drugs in Epzicom).

No doctor worth their salt will routinely prescribe abacavir after a positive HLA test. The point of the test is to rule the drug out as a workable option.

A positive result on the abacavir HLA test does not indicate that you will be more likely to have problems with other HIV drugs. This test is specific to abacavir.

Hope this helps

- matt
"The object is to be a well patient, not a good patient"

Offline eric48

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  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Re: HLA-B5071 testing for Ziagen allergy
« Reply #3 on: January 11, 2011, 06:46:33 PM »
Indeed...

I got my numbers out of memory, thus wrong...

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3000684/?tool=pubmed

gives a precise overview.

There is a 5-8% incidence if you are NOT tested for HLA-B5071, but if the test IS performed and says you should not take ABACAVIR, then you SHOULD NOT.

Sorry for the confusion.

ABACAVIR has its pros and cons even if the test says you can have it. If it says you can't, then this one is ruled out.

There is no incidence on the choice of other meds.

Eric
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 2 months

Offline itsimple

  • Member
  • Posts: 9
Re: HLA-B5071 testing for Ziagen allergy
« Reply #4 on: January 12, 2011, 05:48:43 PM »
Ziagen is listed as an alternative to first line therapy. It has many undesirable side effects and shouldn't be taken by Pregnant women or
anyone with cardiac disease. There were also articles about potential problems if one were  coinfected with Hepatitis, though I can not find them at this time. Also, I would agree about avoiding Ziagen if your test were positive. Your chances for serious adverse reactions would be substantial. And a second opinion from another medical professional would be priceless.

Offline eric48

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Re: HLA-B5071 testing for Ziagen allergy
« Reply #5 on: January 12, 2011, 07:14:12 PM »
And a second opinion from another medical professional would be priceless.

Or useless at this point... His doc did the right thing. Namely, consider one combo that may match patient's other concerns  (we do not know all the details...), then ask for the HLA-B5071 test, which is the normal, standard  procedure

If the doc asked for the test, it is most likely because he/she does not want to take any chances and therefore, now that the result is known, will not take any risk. There is no reason to question that doctor's ability at this point.

The test came back positive: that rules out Abacavir without question. Abacavir WAS a possible option; it is no more.

The OP's concern is whether the  HLA-B5071 test tells something about possible allergic reaction to the OTHER meds, and the answer to this question is, as far as I know (based on all the reading I did on that med that I take), NO.

Eric
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 2 months

Offline legolas613

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  • Posts: 20
Re: HLA-B5071 testing for Ziagen allergy
« Reply #6 on: January 13, 2011, 02:29:59 AM »
I guess I'll find out real quick, my alternate choice of viread, epivir and intelence can be picked at the pharmacy today. My doctor doesn't seem to be too concerned and neither are any of you so that makes me feel better. I already knew that ziagen or epzicom are no longer options as that much was relayed to me by my doctor, I was just a little concerned about potential reactivity to these other meds in light of having a reaction to one realizing other reactions to other meds would come about not because of this allergic reaction to ziagen causing more reactions but rather if one allergy makes it more likely that future reactions of different types can be encountered with these other meds as well. Thanks
« Last Edit: January 13, 2011, 02:35:43 AM by legolas613 »
2009 Oct -- infected.
2009 Nov -- seroconverted.
2010 Feb -- tested HIV+. 
2010 Feb -- CD4=457,33% VL/WBC=3.8k/4.4
2010 Dec -- CD4=568,40% VL/WBC=3.6k/3.7
2011 Jan -- HLA B5071 test +; couldn't use Ziagen.
2011 Jan -- began Viread, Epivir and Intellence.
2011 May -- CD4=409,43% VL/WBC=UD/3.8
2011 Aug -- CD4=404,44% VL/WBC=8.8k/4.0
2011 Sept -- switched to Truvada & boosted Prezista. CD4 suppression, SE and adherance issues.
2011 Nov -- CD4=522,49% VL/WBC=2.3k/3.5
2012 Jan -- discontinued meds. SE and adherance issues, deciding on new regimen.
2012 Feb -- resistance testing revealed mutations: 3 NRTI (incl K65R), 4 NNRTI and 3 PI's.
2012 Apr -- CD4=599,41% VL/WBC=263/3.8
2012 May -- Shingles
2012 Oct -- CD4=493,36% VL/WBC=4.7k/4.4 (still my latest Dr. visit as of 2/01/2014)

Offline Ann

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  • It just is, OK?
    • Num is sum qui mentiar tibi?
Re: HLA-B5071 testing for Ziagen allergy
« Reply #7 on: January 13, 2011, 10:36:08 AM »
I tested negative for the HLA-B5071 and although theoretically this means I'm ok to take abacavir, my doctor said he will not prescribe it for me due to the combined facts of my age (48) and I'm a smoker. He said the cardiac risk was too high when there were other meds available to me.
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Offline richie

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  • Posts: 69
Re: HLA-B5071 testing for Ziagen allergy
« Reply #8 on: January 17, 2011, 08:01:05 PM »
I am allergic to ABC as well, only I found out the hard way years ago (before the test was available).  It was pretty awful -- like having a really really really really bad flu for a month.  Each day, taking the ABC made it even worse.

From your description, you're pretty sensitive to drugs, as am I.  I have been on quite a few HIV meds, and always have a reaction to them -- from rash to worse.  My advice would be to stick with any new med for at least a month, and deal with the side affects (use the tips and tricks on Aidsmeds).  Rashes are easy to deal with (antihistamines), diarhea can be dealt with easily, etc., etc.  After a month, your body usually adjusts and the side affects dissipate.  If you can't beat the side affects, then it's time to reassess.  Looking at your new regimen, you should do brilliantly.

Best,

--rich

Offline eric48

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  • Posts: 1,169
  • @HIVPharmaCure & tinyurl.com/HIVPharmaCure
Re: HLA-B5071 testing for Ziagen allergy
« Reply #9 on: January 18, 2011, 05:23:21 PM »
Looking at your new regimen, you should do brilliantly.

Best,

--rich

same feeling here... Good luck! Eric
NVP/ABC/3TC/... UD; CD4 > 1000; CD4/CD8 ~ 2.0   safety stock : 2 months

 


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