{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T06:05:07Z","timestamp":1780553107429,"version":"3.54.1"},"reference-count":199,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>Human leukocyte antigen (HLA) polymorphisms are central to anti-infective pharmacogenetics and to inter-individual variability in infection outcomes and vaccine responses, but clinical relevance depends on whether an association changes treatment or prevention decisions. This narrative review is organized around two complementary pillars: first, severe, typically T cell\u2013mediated adverse drug reactions to anti-infective agents, where HLA can support prevention when genetic effect, phenotype precision, and therapeutic alternatives converge; and second, selected, replicated HLA-region associations with infection outcomes or vaccine immunogenicity, where biological effects may be robust yet individual-level clinical translation is often limited. Within the adverse drug reaction pillar, the clearest preventive paradigm remains HLA-B*57:01-guided abacavir prescribing, with additional high-signal examples including dapsone hypersensitivity and flucloxacillin-induced liver injury that illustrate how large effect sizes do not always justify routine screening. Within the infection and vaccine pillar, HIV, HCV, and hepatitis B vaccine response provide the strongest evidence that HLA shapes clinically relevant host-response heterogeneity. Across both domains, the key pharmacological distinction is between mechanistically persuasive associations and those that are sufficiently robust, transportable, and decision-relevant to change practice.<\/jats:p>","DOI":"10.3389\/fphar.2026.1846785","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T05:40:28Z","timestamp":1780551628000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Human leukocyte antigen pharmacogenetics in infectious diseases: anti-infective drug toxicity and host immune response"],"prefix":"10.3389","volume":"17","author":[{"given":"Simone","family":"Negrini","sequence":"first","affiliation":[{"name":"Allergy and Immunology Unit, Mauriziano Hospital","place":["Turin, Italy"]},{"name":"Department of Medical Sciences, University of Turin","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Nicola","sequence":"additional","affiliation":[{"name":"Allergy and Immunology Unit, Mauriziano Hospital","place":["Turin, Italy"]},{"name":"Department of Medical Sciences, University of Turin","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iuliana","family":"Badiu","sequence":"additional","affiliation":[{"name":"Allergy and Immunology Unit, Mauriziano Hospital","place":["Turin, Italy"]},{"name":"Department of Medical Sciences, University of Turin","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Quinternetto","sequence":"additional","affiliation":[{"name":"Allergy and Immunology Unit, Mauriziano Hospital","place":["Turin, Italy"]},{"name":"Department of Medical Sciences, University of Turin","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Vitali","sequence":"additional","affiliation":[{"name":"Allergy and Immunology Unit, Mauriziano Hospital","place":["Turin, Italy"]},{"name":"Department of Medical Sciences, University of Turin","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Lo Sardo","sequence":"additional","affiliation":[{"name":"Allergy and Immunology Unit, Mauriziano Hospital","place":["Turin, Italy"]},{"name":"Department of Medical Sciences, University of Turin","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luisa","family":"Brussino","sequence":"additional","affiliation":[{"name":"Allergy and Immunology Unit, Mauriziano Hospital","place":["Turin, Italy"]},{"name":"Department of Medical Sciences, University of Turin","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.coi.2021.04.009","article-title":"Major histocompatibility complex (MHC) class I and class II proteins: impact of polymorphism on antigen presentation","volume":"70","author":"Abualrous","year":"2021","journal-title":"Curr. 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