Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
J Infect Dis. 2011 Jun 15;203(12):1807-14. doi: 10.1093/infdis/jir192.
Human leukocyte antigen (HLA) class I and II genotype is associated with clearance of hepatitis C virus (HCV) infection, but little is known regarding its relation with HCV viral load or risk of liver disease in patients with persistent HCV infection.
High-resolution HLA class I and II genotyping was conducted in a prospective cohort of 519 human immunodeficiency virus (HIV)-seropositive and 100 HIV-seronegative women with persistent HCV infection. The end points were baseline HCV viral load and 2 noninvasive indexes of liver disease, fibrosis-4 (FIB-4), and the aspartate aminotransferase to platelet ratio index (APRI), measured at baseline and prospectively.
DQB10301 was associated with low baseline HCV load (β = -.4; 95% confidence interval [CI], -.6 to -.3; P < .00001), as well as with low odds of FIB-4-defined (odds ratio [OR], .5; 95% CI, .2-.9; P = .02) and APRI-defined liver fibrosis (OR, .5; 95% CI, .3-1.0; P = .06) at baseline and/or during follow-up. Most additional associations with HCV viral load also involved HLA class II alleles. Additional associations with FIB-4 and APRI primarily involved class I alleles, for example, the relation of B1503 with APRI-defined fibrosis had an OR of 2.0 (95% CI, 1.0-3.7; P = .04).
HLA genotype may influence HCV viral load and risk of liver disease, including DQB1*0301, which was associated with HCV clearance in prior studies.
人类白细胞抗原(HLA)I 类和 II 类基因分型与丙型肝炎病毒(HCV)感染的清除有关,但对于其与 HCV 病毒载量或持续性 HCV 感染患者肝病风险的关系知之甚少。
对 519 名人类免疫缺陷病毒(HIV)阳性和 100 名 HIV 阴性的持续性 HCV 感染患者进行了前瞻性队列研究,进行了高分辨率 HLA I 类和 II 类基因分型。终点是基线 HCV 病毒载量和 2 个非侵入性的肝病指标,纤维化 4 指数(FIB-4)和天冬氨酸转氨酶与血小板比值指数(APRI),在基线和前瞻性测量。
DQB10301 与低基线 HCV 载量相关(β=-.4;95%置信区间[CI],-.6 至-.3;P<0.00001),与 FIB-4 定义的低几率相关(比值比[OR],.5;95%CI,.2-.9;P=0.02)和 APRI 定义的肝纤维化(OR,.5;95%CI,.3-1.0;P=0.06)在基线和/或随访时。大多数与 HCV 病毒载量相关的额外关联也涉及 HLA Ⅱ类等位基因。与 FIB-4 和 APRI 的其他关联主要涉及 I 类等位基因,例如,B1503 与 APRI 定义的纤维化之间的关系的比值比为 2.0(95%CI,1.0-3.7;P=0.04)。
HLA 基因型可能影响 HCV 病毒载量和肝病风险,包括在先前研究中与 HCV 清除相关的 DQB1*0301。