Human leukocyte antigen class II and III alleles and severity of hepatitis C virus–related chronic liver disease

• Published in: Hepatology (Baltimore, Md.) Vol. 29; no. 4; pp. 1272 - 1279
• Main Authors: Asti, Margherita, Martinetti, Miryam, Zavaglia, Claudo, Cuccia, Maria Clara, Gusberti, Laura, Tinelli, Carmine, Cividini, Agostino, Bruno, Savino, Salvaneschi, Laura, Ideo, Gaetano, Mondelli, Mario U., Silini, Enrico M.
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA W.B. Saunders 01.04.1999; Wiley
• Subjects: Adult; Aged; Alleles; ATP-Binding Cassette Sub-Family B Member 2; ATP-Binding Cassette Transporters - genetics; ATP-Binding Cassette, Sub-Family B, Member 3; Biological and medical sciences; Cohort Studies; Complement C4a - genetics; Complement C4b - genetics; Female; Gastroenterology. Liver. Pancreas. Abdomen; Gene Frequency; Genes, MHC Class II - genetics; Hepatitis C, Chronic - blood; Hepatitis C, Chronic - immunology; Heterozygote; HLA Antigens - genetics; Humans; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Lymphotoxin-alpha - genetics; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Severity of Illness Index; Tumor Necrosis Factor-alpha - genetics; Human; HLA-System; Immune response; Hepatic disease; Host; Infection; Virus; Chronic; Immunology; Gene; Viral disease; Modulation; Digestive diseases; Severity score; Flaviviridae; Predictive factor; Hepatitis C virus; Hepacivirus; Comparative study; Viral hepatitis C
• ISSN: 0270-9139; 1527-3350
• DOI: 10.1002/hep.510290445

Hepatitis C outcome is likely related both to viral factors and host's immune responses. We correlated the severity of liver disease with human leukocyte antigen (HLA) genes (C4A, C4B, TNFA, TNFB, DRB1, DRB3, DRB4, DRB5, DQA1, DQB1, TAP1, and TAP2) in three groups of subjects: 99 patients with chronic hepatitis, 41 asymptomatic carriers, and 179 uninfected controls. Patients with grade/stage 3 to 4 hepatitis significantly differentiated for their low frequency of alleles TNFB*1, DRB1*1104, and DRB3*03, which had a protective role, and high frequency of allele DRB1*1001, which was associated with disease severity. HLA‐DRB*11 subtypes were differentially distributed: DRB1*1104 was most frequent in carriers, whereas DRB1*1101 was more frequent in patients. The TAP1C,2A haplotype was also underrepresented in patients with respect to controls. Finally, a decrease of heterozygous subjects was observed in patients with respect to carriers at the DQB1 locus. Multivariate analysis by correspondence analysis and multiple logistic regression indicated that age, sex, and hepatitis C virus (HCV) type were the strongest risk factors; however, some immunogenetic variables (TNFB*1, DRB1*1104, and DRB3*03) showed an independent contribution, especially in comparing patients with extreme manifestations of disease. The involvement of different genes in various HLA subregions suggests that anti‐HCV responses are modulated by a complex gene interplay rather than by single alleles