Editorial Commentary:Genetic Screening to Prevent Abacavir Hypersensitivity Reaction: Are We There Yet?

Abstract

Pharmacogenetics is hardly a new field, with early discoveries of genetic differences in drug-metabolizing enzymes dating back to the early 1960s. However, despite the increasing knowledge base regarding variation in drug response and toxicity related to pharmacogenetic factors and the simplification and increased availability of molecular technologies, there have been major barriers to the introduction of genetic testing into routine clinical practice [1]. Factors favoring uptake of a genetic test into clinical practice are shown in table 1. The lack of incorporation of testing into practice has related primarily to (1) the availability of laboratory markers that correctly phenotype drug response or toxicity (e.g., drug levels for anticonvulsants or international normalized ratio for warfarin), (2) the lack of standardized clinical or laboratory guidelines or algorithms for the interpretation of genetic test results, and (3) the paucity of evidence-based medicine showing that the prospective use of pharmacogenetic screening positively impacts patient outcome.