An exploratory case-control study of 37 Thai adults with confirmed beta-lactam hypersensitivity identified HLA-DQA1*01:04 and HLA-DQA1*05:05 candidate signals after Bonferroni correction, with the latter stronger for immediate reactions. Small size, population controls and sensitivity-instability mean the findings are not ready for screening or drug avoidance.
Key findings
- Among 37 cases, 62.16% were immediate, 21.62% mild non-immediate and 16.22% SCAR. HLA-DQA1*01:04 had OR 8.79 (95% CI 2.01-29.87; adjusted p=0.029) and *05:05 OR 5.03 (1.66-12.74; p=0.029); *05:05 in immediate cases had OR 6.96 (2.01-19.25; p=0.018). Drug-specific signals were sensitivity-unstable.
Why this matters globally
HLA-drug associations are population-specific, and Thai evidence addresses ancestry gaps in pharmacogenomics.
Thai researcher contribution
Chiang Mai, Thammasat, Siriraj, Mahidol and Ramathibodi teams combined clinically confirmed phenotypes, sequencing and regional synthesis.
Limitations to consider
Only 37 cases and tiny subgroups were available. External population controls invite stratification and batch effects; intervals are wide, tests numerous and some signals non-robust. Predictive values and cost-effectiveness are unknown.