HLA-linked control of susceptibility to tuberculoid leprosy and association with HLA-DR types.

In an attempt to confirm an HLA-linked effect on the course of Mycobacterium leprae infection observed in families from Surinam (South America), we conducted a similar family study in an endemic area in India. We observed a significant (P less than .05) excess of identical HLA-GLO haplotypes only from healthy parents among siblings affected with tuberculoid leprosy. Compared with healthy controls, unrelated patients with tuberculoid leprosy (n = 15) showed a significant heterogeneity at the HLA-DR locus (P less than .05). This heterogeneity was caused by an increased frequency of HLA-DRw2 (.93 versus .53, P less than .05), particularly of DRw2 homozygotes (.53 versus .11, P less than .005), and a decreased frequency of HLA-DRw6 (.07 versus .58, P less than .005). We observed a significant (P = .03) preferential segregation of DRw2 from DRw2 heterozygous parents not affected with tuberculoid leprosy to children with the tuberculoid type of the disease. These data confirm an HLA-linked control of susceptibility to tuberculoid leprosy only, and suggest a recessive inheritance of this trait for which HLA-Drw2 appears to be a genetic marker.