Validation study of hla-b* 13:01 as a biomarker of dapsone hypersensitivity syndrome in leprosy patients in Indonesia

Hana Krismawati, Astrid Irwanto, Arry Pongtiku, Ishak Darryl Irwan, Yustinus Maladan, Yuli Arisanti Sitanggang, Tri Wahyuni, Ratna Tanjung, Yonghu Sun, Hong Liu, Furen Zhang, Antonius Oktavian, Jianjun Liu

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)


Leprosy is a stigmatizing, chronic infection which degenerates the nervous system and often leads to incapacitation. Multi-drug therapy which consists of dapsone, rifampicin and clofazimine has been effective to combat this disease. In Indonesia, especially in Papua Island, leprosy is still a problem. Furthermore, there had been higher reports of Dapsone Hypersensitivity Syndrome (DHS) which also challenges leprosy elimination in certain aspects. Globally, DHS has a prevalence rate of 1.4% and a fatality rate up to 13%. The aim of this study is to validate HLA-B*13:01, a previously discovered biomarker for DHS in the Chinese population, as a biomarker for DHS in the Papua population.This is a case-control study of 34 leprosy patients who presented themselves with DHS (case subjects) and 52 leprosy patients without DHS (control subjects). Patients were recruited from 2 provinces: Papua and West Papua. DNA was extracted from 3 ml blood specimens. HLA-B alleles were typed using the gold-standard sequence based typing method. Results were then ana-lysed using logistic regression and risk assessment was carried out. The results of HLA-typ-ing showed that HLA-B*13:01 was the most significant allele associated with DHS, with odds ratio = 233.64 and P-value = 7.11×10−9, confirming the strong association of HLA-B*13:01 to DHS in the Papua population. The sensitivity of this biomarker is 91.2% and specificity is 96.2%, with an area under the curve of 0.95. HLA-B*13:01 is validated as a bio-marker for DHS in leprosy patients in Papua, Indonesia, and can potentially be a good pre-dictor of DHS to help prevent this condition in the future.

Original languageEnglish
Article numbere0008746
Pages (from-to)1-11
Number of pages11
JournalPLoS Neglected Tropical Diseases
Issue number10
Publication statusPublished - Oct 2020


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