Screening individuals for the expression of certain variant alleles of HLA genes before initiating treatment with particular SCARs-inducing drugs is recommended. These recommendations typically apply only to specific populations that have a significant chance of expressing the indicated variant since screening of populations with extremely low incidences of expressing the variant allele is considered cost-ineffective. Individuals expressing the HLA allele associated with sensitivity to an indicated drug should not be treated with the drug. These recommendations include: *Carbamazepine: The Taiwan and USA Food and Drug Administrations recommend screening for HLA-B*15:02 in certain Asian groups before carbamazepine treatment. This has been implemented in Taiwan, Hong Kong, Singapore, and many medical centers in Thailand and Mainland China. *Allopurinol: The American College of Rheumatology guidelines for the management of gout recommend HLA-B*58:01 screening before allopurinol treatment. This is provided in many medical centers in Taiwan, Hong Kong, Thailand, and Mainland China. *Abacavir: The USA Food and Drug Administration recommends screening for HLA-B*57:01 in the treatment of HIV with abacovir in Caucasian populations. This screening is widely implemented. It has also been suggested that all individuals found to express this HLA serotype avoid treatment with abacovir. Current trials are underway to evaluate the cost-effectiveness of genetic screening for HLA-B*13:01 to prevent dapsone-induced SCARs in China and Indonesia. Similar trials are underway in Taiwan to prevent phenytoin-induced SCARs in individuals expressing the CYP2C9*3 allele of CYP2C9 or a series of HLA alleles.
Severe cutaneous adverse reactions
Chronic toxicity
Acute toxicity
Progressive disease
Autoimmune/inflammatory syndrome induced by adjuvants
Serious Hazards of Transfusion
Allergies in children
Limited symptom attack