Pharmacogenomics Application in HIV Treatment Optimisation at University of Benin Teaching Hospital

Pharmacogenomics uses genetic variation to predict individual drug response, enabling personalised and safer treatment protocols. In HIV management, pharmacogenomics has particular relevance for antiretroviral toxicity prediction, particularly for abacavir hypersensitivity (HLA-B*57:01) and efavirenz-related central nervous system effects (CYP2B6 516G>T). This study assessed the feasibility and clinical utility of pharmacogenomic testing to optimise HIV treatment at the University of Benin Teaching Hospital (UBTH), Edo State, South South Nigeria. A prospective pilot study enrolled 100 HIV-positive patients initiating first-line antiretroviral therapy. Genomic DNA from peripheral blood was genotyped for HLA-B*57:01 and CYP2B6 516G>T polymorphisms using PCR-SSO and PCR-RFLP methods respectively. Clinical outcomes including adverse drug reactions, viral load suppression at six months, and adherence were monitored. The CYP2B6 516TT (poor metaboliser) genotype was detected in a significant proportion, consistent with reported African population frequencies. Patients with the 516TT genotype demonstrated higher efavirenz plasma exposure, correlating with neuropsychiatric adverse effects. HLA-B*57:01 was absent in this cohort, consistent with its rarity in African populations. These findings support pharmacogenomic-guided ART prescribing at UBTH. Keywords: pharmacogenomics, HIV treatment, CYP2B6, efavirenz, University of Benin Teaching Hospital