Division of Viral Pathogenesis, Beth Israel Deaconess Medical Center, E/CLS-1005, 330 Brookline Avenue, Boston, MA 02215, USA.
J Neurovirol. 2010 Feb;16(1):41-7. doi: 10.3109/13550280903552438.
Because human leukocyte antigen (HLA) associations with various infectious diseases have recently been reported, we examined the role of HLA class I alleles in the development of progressive multifocal leukoencephalopathy (PML) or its outcome in 152 patients, including 123 Caucasians and 29 African Americans. Compared to a human immunodeficiency virus positive (HIV+) control population, we observed decreased frequency of HLA-A3 (P = 0.03) in the Caucasian PML group, whereas B18 (P = 0.02), was more frequent. No such difference was found among African American PML patients. We then sought to characterize differences in HLA between PML progressors, whose survival doesn't exceed 1 year, and survivors. Caucasian survivors were less likely to harbor A68 (P = 0.01), whereas African American survivors less frequently displayed Cw4 (P = .01). However, none of these differences reached statistical significance after Bonferroni correction for multiple testing. Further investigations are needed to assess the role of genetics in the incidence of PML or its outcome. Physicians may exercise caution in the use of immunomodulatory medications in patients whose genetic background is associated with an increased risk of PML.
由于人类白细胞抗原 (HLA) 与各种传染病的关联最近已被报道，我们研究了 HLA Ⅰ类等位基因在 152 名患者（包括 123 名白人和 29 名非裔美国人）中进展性多灶性白质脑病 (PML) 的发生或结局中的作用。与人类免疫缺陷病毒阳性 (HIV+) 对照组相比，我们观察到白种人 PML 组中 HLA-A3 的频率降低（P=0.03），而 B18 更为常见（P=0.02）。在非裔美国人 PML 患者中未发现这种差异。然后，我们试图描述 PML 进展者（其生存时间不超过 1 年）与幸存者之间 HLA 的差异。白种人幸存者不太可能携带 A68（P=0.01），而非裔美国人幸存者较少显示 Cw4（P=0.01）。然而，在经过多次测试的 Bonferroni 校正后，这些差异均未达到统计学意义。需要进一步研究以评估遗传因素在 PML 的发生率或其结局中的作用。对于具有 PML 风险增加的遗传背景的患者，医生在使用免疫调节药物时可能需要谨慎。
