Harris Rebecca A, Sugimoto Kazushi, Kaplan David E, Ikeda Fusao, Kamoun Malek, Chang Kyong-Mi
Division of Gastroenterology, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, PA 19014, USA.
Hepatology. 2008 Jul;48(1):70-9. doi: 10.1002/hep.22287.
The outcome of hepatitis C virus (HCV) infection has been associated with antiviral CD4 T cell response, human leukocyte antigens (HLA) class II genotypes, and ethnicity. However, HLA class II molecules restrict the nature of CD4 T cell response, and HLA distributions differ between ethnic groups. In this study, we asked whether HLA class II genotypes associated with HCV clearance are shared between Caucasian and African Americans and whether they contribute to enhanced antiviral CD4 T cell response. In a cohort of 93 HCV-seropositive subjects from Northeast America with defined ethnicity, virological outcome, and HCV-specific CD4 T cell proliferation, we confirm the previously reported associations between HCV clearance and two HLA types (DQB103, DRB111) while identifying a new association with DRB302. Strikingly, these associations were identified only among Caucasian [DQB103: odds ratio (OR), 10.4; P = 0.031, DRB111: OR, 7.0, P = 0.019; DRB302: OR, 8.3, P = 0.005; DQB103-DRB302: OR, 13.5, P = 0.001) but not among African American patients. Furthermore, although HLA DQB103, DRB111, and DRB3*02 genotypes were associated with increased HCV-specific CD4 T cell response in univariate analyses, these associations were lost when controlling for virological outcomes.
We conclude that the immunogenetic basis for HCV clearance differs between ethnic groups and that the association between HLA class II and HCV clearance is not directly explained by antiviral CD4 T cell response.
丙型肝炎病毒(HCV)感染的结果与抗病毒CD4 T细胞反应、人类白细胞抗原(HLA)II类基因型以及种族有关。然而,HLA II类分子限制了CD4 T细胞反应的性质,并且HLA分布在不同种族之间存在差异。在本研究中,我们询问与HCV清除相关的HLA II类基因型在白种人和非裔美国人之间是否相同,以及它们是否有助于增强抗病毒CD4 T细胞反应。在一组来自美国东北部的93名HCV血清阳性受试者中,这些受试者具有明确的种族、病毒学结果和HCV特异性CD4 T细胞增殖情况,我们证实了先前报道的HCV清除与两种HLA类型(DQB103、DRB111)之间的关联,同时发现了与DRB302的新关联。令人惊讶的是,这些关联仅在白种人中被发现[DQB103:优势比(OR),10.4;P = 0.031,DRB111:OR,7.0,P = 0.019;DRB302:OR,8.3,P = 0.005;DQB103 - DRB302:OR,13.5,P = 0.001],而非裔美国患者中未发现。此外,尽管在单变量分析中HLA DQB103、DRB111和DRB3*02基因型与HCV特异性CD4 T细胞反应增加有关,但在控制病毒学结果时,这些关联消失了。
我们得出结论,HCV清除的免疫遗传学基础在不同种族之间存在差异,并且HLA II类与HCV清除之间的关联不能直接通过抗病毒CD4 T细胞反应来解释。