Vietnamese pharmacogenomic variation in global context: a systematic review and meta-analysis for clinical implementation.

Allele frequencies of actionable pharmacogenes — VKORC1, SLCO1B1, ABCB1, ABCG2, CYP2C19, NAT2, CYP3A5 — in a South-East Asian population, compared with reference superpopulations.

Local allele frequencies determine the yield of a pharmacogenomic programme, and broad ancestry categories do not capture them faithfully. This systematic review and meta-analysis, conducted under a registered protocol and PRISMA 2020, searched international and Vietnamese sources to 30 December 2025: from 207 records, 52 reports were retained in the review and 46 contributed to the primary meta-analysis, covering 108 variant representations across 25 pharmacogenes. The highest frequencies were for VKORC1 -1639G>A (89.91%; 95% CI 81.13-94.86), VKORC1 1173C>T (85.43%), SLCO1B1 c.388A>G (75.95%), ABCB1 3435C>T (40.28%) and ABCG2 c.421C>A (36.00%). In the comparison with 1000 Genomes superpopulations, 18 of the 20 analysable variants sat within five percentage points of the East Asian superpopulation, the two notable gaps being ABCB1 3435C>T (-19.9 points) and the allele CYP3A5*3 (-7.2 points; estimated frequency 60.81%). Ninety-five of the 108 representations, however, rest on a single source.

Synthesis written by Geno'X. For the full original abstract, please refer to the source publication.

The operational conclusion is finer than the usual slogan about population diversity: Vietnam sits close to the East Asian reference for 18 of 20 variants, yet is not interchangeable with it, and the widest gap falls on ABCB1. The real limitation is robustness rather than method: 95 of the 108 representations rest on a single source, which rules out treating most of these frequencies as reliable parameters for sizing a genotyping programme. The genuinely usable estimates are the small core documented by several independent sources, foremost those for VKORC1 in warfarin dosing and that of the loss-of-function allele CYP2C19*2 (27.90%).

Analysis by Dr Thibaut Benquey