Scotto G, Fazio V, D'Alessandro G, Monno L, Saracino A, Palumbo E, Angarano G
UO Infectious Diseases, University of Foggia, Italy.
J Biol Regul Homeost Agents. 2003 Oct-Dec;17(4):316-21.
The aim was to confirm the influence of HLA Class II antigens on the progression of HCV infection and to assess the relationship between these antigens and histological damage, HCV viral load and HCV genotype. 143 patients were enrolled and divided into three groups. Group A included 34 anti-HCV positive, HCV-RNA negative patients with ALT persistently normal; group B included 39 patients with HCV-RNA positive and abnormal ALT level; group C included 70 normal subjects. Serological HCL typing was performed with lymphocytotoxicity test by Terasaky and McClelland, using lymphobeads HLC class II. The frequency of HLA DR11 (5) was significantly higher in the control group (52.9%) and in group A (64.7%), than in group B (28.2%). Allele HLA DR6 was demonstrated in a similar proportion (26%) among control group and group B, while HLA DR14 (6) was less frequent among controls (18% vs 1.4%). In group A the frequency of HLA DR14 (6) was 3% compared to group B, HLA DR17 (3) was prevalent (15.4%) in group B. Liver damage was associated with the detection of HLA DR14 (6) and HLD DR17 (3) antigens. Significantly lower levels of HCV-RNA were measured in subjects with HLA DR11 (5) than in these with either DR6 or DR17 (3). HLA class II antigens appear crucial for resolution or progression of HCV hepatitis. The punctual identification of these genetic factors may, therefore, prove to be useful in predicting disease evolution, in guiding the appropriate therapy for patients with poor prognosis, and in encouraging the development of now therapeutic strategies.
目的是确认人类白细胞抗原（HLA）II类抗原对丙型肝炎病毒（HCV）感染进展的影响，并评估这些抗原与组织学损伤、HCV病毒载量及HCV基因型之间的关系。纳入143例患者并分为三组。A组包括34例抗-HCV阳性、HCV-RNA阴性且丙氨酸氨基转移酶（ALT）持续正常的患者；B组包括39例HCV-RNA阳性且ALT水平异常的患者；C组包括70名正常受试者。采用Terasaky和McClelland的淋巴细胞毒性试验，使用淋巴细胞微珠HLC II类进行血清学HCL分型。对照组（52.9%）和A组（64.7%）中HLA DR11（5）的频率显著高于B组（28.2%）。对照组和B组中HLA DR6等位基因的比例相似（26%），而对照组中HLA DR14（6）的频率较低（18%对1.4%）。与B组相比，A组中HLA DR14（6）的频率为3%，HLA DR17（3）在B组中较为普遍（15.4%）。肝损伤与HLA DR14（6）和HLD DR17（3）抗原的检测相关。HLA DR11（5）受试者的HCV-RNA水平显著低于携带DR6或DR17（3）的受试者。HLA II类抗原似乎对HCV肝炎的缓解或进展至关重要。因此，准确识别这些遗传因素可能有助于预测疾病演变、指导预后不良患者的适当治疗以及推动新治疗策略的开发。
