Internal Medicine (East Africa); Pathology (East Africa)
We read with interest the article published in your Journal entitled “Real-world persistence with antiretroviral therapy for HIV in the United Kingdom: a multicentre retrospective cohort study”1 which concluded that treatment discontinuation attributable to toxicity profile is not an uncommon event. They also acknowledged lack of data collection on HLA-B*5701 status, which would heavily influence initial ART regimen and the choice to discontinue medication. Of the 25.6 million living with Human Immunodeficiency Virus (HIV) in Africa, an estimated 1.6 million people live in Kenya.2 With an HIV prevalence of 5.6%, Kenya has upscaled HIV treatment and care in the past 10 years to cover 80% of those requiring therapy.2 The current Kenyan guidelines, as in the case of many developing countries, rely on WHO guidelines.3,4 Abacavir is a nucleoside reverse transcriptase inhibitor (NRTI) used for treating HIV infection and is recommended as both first and second line drug options. A barrier to prescribing of abacavir in Kenya is the fear of Abacavir Hypersensitivity Reaction, and this has been compounded by the lack of availability of testing for HLA-B*5701 testing. The Kenyan population is heterogeneous, consisting of 42 tribes with the main ethnic groups being Bantu, Nilotes and Cushites. In our study, we have determined the prevalence of HLAB* 5701 in the black HIV positive population in Kenya using a cross sectional epidemiological survey. We recruited 1004 patients from three HIV centers: the Aga Khan University Hospital Nairobi, Mbagathi Hospital and Machakos Hospital in Kenya after ethics approval was sought from the Research Ethics Committee in Aga Khan University and from the ethics boards of Mbagathi and Machakos hospitals.
Journal of Infection
(2018). Prevalence of HLA-B*5701 in a Kenyan population with HIV infection. Journal of Infection, 76(2), 212-124.
Available at: https://ecommons.aku.edu/eastafrica_fhs_mc_intern_med/85