association of human leukocyte antigen alleles with carbamazepine- or lamotrigine-induced stevens-johnson syndrome and toxic epidermal necrolysis in an iranian population: a case-control study

Background: genetic diversity in human leukocyte antigen (hla) alleles across populations is a significant risk factor for drug-induced severe cutaneous adverse reactions (scars), e.g., carbamazepine (cbz)- and lamotrigine (ltg)-induced stevens-johnson syndrome (sjs), and toxic epidermal necrolysis (ten). the present study aimed to investigate the frequency of different hla alleles in iranian patients with cbz- and ltg-induced sjs/ten.methods: a case-control study was conducted from 2011 to 2018 at various hospitals affiliated with shiraz university of medical sciences (shiraz, iran). a total of 31 patients receiving anticonvulsant drugs (czb or ltg) were recruited and divided into two groups. the drug-induced group (n=14) included hospitalized patients due to cbz- or ltg-induced sjs/ten. the drug-tolerant group (n=17) included individuals receiving cbz or ltg for at least three months with no adverse effects. in addition, 46 healthy individuals (control group) were recruited. the frequency of hla-a, -b, and -drb1 alleles in patients with czb- or ltg-induced sjs/ten was investigated. hla typing was performed using the allele-specific polymerase chain reaction method. the chi square test and fisher’s exact test were used to determine a potential association between sjs/ten and hla alleles. p<0.05 was considered statistically significant.results: cbz- or ltg-induced sjs/ten was not significantly associated with hla alleles. however, hla-drb1*01 showed a significantly higher frequency in patients with cbz-induced sjs/ten than the cbz-tolerant patients (30% vs. 9%, p=0.07). conclusion: overall, no significant association was found between cbz- or ltg-induced sjs/ten and hla alleles. further large-scale studies are required to substantiate our findings.