02506nas a2200301   4500000000100000008004100001260001000042653003800052653001200090653001600102653000800118100002200126700001300148700001300161700001300174700002300187700001300210700002300223700001400246700001300260700001400273245014300287856005200430300000900482490000700491520169200498022001402190       2025                            d  bLepra10aDapsone hypersensitivity syndrome10aleprosy10aHLA-B*13:0110aHLA1 aLinuwih Menaldi S1 aRahayu T1 aGibran K1 aWidaty S1 aHandaru Priyanto M1 aFriska D1 aAndayani Adriono G1 aKartika E1 aAmalia V1 aIrawati Y00aThe role of the HLA-B*13:01 allele in leprosy patients with dapsone hypersensitivity syndrome (DHS): A systematic review and meta-analysis  uhttps://leprosyreview.org/article/96/3/20-25047  a1-140 v963 a<p><strong>Objectives</strong></p>

<p>To investigate the association between the HLA-B<sup>*</sup>13:01 allele and dapsone hypersensitivity syndrome (DHS) in leprosy patients undergoing dapsone therapy.</p>

<p><strong>Methods</strong></p>

<p>A systematic review and meta-analysis were conducted following PRISMA guidelines. Databases, including MEDLINE, Embase, Cochrane, Scopus, and SpringerLink, were searched up to March 2025. Eligible studies were case-control or cohort designs reporting HLA-B*13:01 frequencies in DHS cases versus dapsone tolerant controls. Data extraction, quality assessment via the Newcastle-Ottawa Scale, and statistical synthesis using RevMan 5.4 were performed.</p>

<p><strong>Results</strong></p>

<p>Three eligible case-control studies were included, comprising 130 DHS cases, 1188 dapsone-tolerant leprosy patients, and 2040 healthy controls. A strong association was found between HLA-B13:01 and DHS, with a pooled OR of 82.28 [95% CI: 23.38–289.56]. HLA-B13:01 was present in 85.5%–91.2% of DHS cases compared to 3.85%–14.3% of dapsone-tolerant controls. Diagnostic accuracy was high, with sensitivity of 85.5%–91.2%, specificity of 85.7%–96.2%, and negative predictive values &gt;97%. The AUC ranged from 0.89 to 0.95. Heterogeneity was moderate (I<sup>2</sup>&nbsp;= 62%, P = 0.07), and all studies showed low risk of bias.</p>

<p><strong>Conclusions</strong></p>

<p>HLA-B<sup>*</sup>13:01 is strongly associated with DHS in leprosy patients. Its high diagnostic accuracy supports routine screening before dapsone initiation, particularly in endemic regions, to reduce the risk of severe hypersensitivity reactions.</p>
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