Cramp M E, Carucci P, Underhill J, Naoumov N V, Williams R, Donaldson P T
Institute of Liver Studies, King's College Hospital, London, UK.
J Hepatol. 1998 Aug;29(2):207-13. doi: 10.1016/s0168-8278(98)80005-6.
BACKGROUND/AIMS: Hepatitis C virus (HCV) infection becomes chronic in most cases, with only 10-20% of those infected not developing persistent viraemia. The immune response to HCV may be an important determinant of disease resolution and can be influenced by a number of host factors. The aim of this study was to assess the role of host HLA class II type in influencing viral clearance or susceptibility to chronic HCV infection.
We have compared the distribution of HLA DRB1, DQA1 and DQB1 alleles in 49 patients with spontaneous clearance of HCV infection (HCV antibody positive but persistently HCV RNA negative), with 55 chronically infected patients and 134 racially matched controls.
Three alleles were found significantly more frequently in patients with spontaneous viral clearance compared to those with chronic infection-DRB104 (pc=0.0022, odds ratio OR=4.52), DQA103 (pc=0.0012, OR=4.69) and DQB10301 (pc=0.0078, OR=5.09). DQB10302 was found at reduced frequency in all HCV-antibody-positive patients compared to controls (pc=0.0063).
DRB104, DQA103 and DQB10301 are associated with spontaneous clearance of HCV viraemia, with the primary association likely to be with DQB10301 and the associations with DRB104 and DQA103 being due to linkage. In addition, DQB1*0302 is associated with protection from HCV infection. These findings suggest that host HLA class II genotype is an important factor in determining the outcome of infection with hepatitis C virus.
背景/目的：丙型肝炎病毒（HCV）感染在大多数情况下会发展为慢性，只有10%-20%的感染者不会出现持续性病毒血症。对HCV的免疫反应可能是疾病缓解的重要决定因素，并且会受到多种宿主因素的影响。本研究的目的是评估宿主HLA II类分型在影响病毒清除或慢性HCV感染易感性方面的作用。
我们比较了49例HCV感染自发清除患者（HCV抗体阳性但HCV RNA持续阴性）、55例慢性感染患者和134例种族匹配对照者中HLA DRB1、DQA1和DQB1等位基因的分布情况。
与慢性感染患者相比，自发病毒清除患者中发现三种等位基因的频率显著更高——DRB104（pc=0.0022，优势比OR=4.52）、DQA103（pc=0.0012，OR=4.69）和DQB10301（pc=0.0078，OR=5.09）。与对照相比，在所有HCV抗体阳性患者中发现DQB10302的频率降低（pc=0.0063）。
DRB104、DQA103和DQB10301与HCV病毒血症的自发清除相关，主要关联可能与DQB10301有关，而与DRB104和DQA103的关联可能是由于连锁关系。此外，DQB1*0302与预防HCV感染相关。这些发现表明宿主HLA II类基因型是决定丙型肝炎病毒感染结局的重要因素。
