HLA-DQA1基因多态性和HBV感染结局的关联

Association between HLA-DQA1 gene polymorphism and the outcomes of hepatitis B virus infection

目的探讨人类白细胞抗原（HLA）DQAI基因多态性与乙型肝炎病毒（HBV）感染临床结局的关联。方法临床收集慢性乙型肝炎（120例）、慢性HBV携带者（60例）、自限性HBV感染者（60例）三组病例，前两组诊断均经肝活检证实。聚合酶链反应序列特异性引物（PCR-SSP）法检测HIA-DQA1基因型，比较组间基因频率的差异。结果（1）HLA-DQA1＊0201在慢性乙型肝炎组的分布频率显著高于自限性HBV感染组（38.3％ vs 5.8％，P〈0.001，A=10.04，95％ CI：4.48—22.48）；HLA-DQA1＊0102的分布频率显著低于自限性HBV感染组（9.6％ vs 36.7％，P〈0.001，A=0.183，95％ CI：0.10—0.32）。（2）HLA-DQA1＊0201在慢性乙型肝炎组的分布频率显著高于慢性HBV携带者组（38.3％vs 7.5％，P〈0.01，A=7.667，95％ CI：3.7—15.87）；HLA-DQA1＊0102的分布频率显著低于慢性HBV携带者（20％vs 9.6％，P〈0.01，A=0.424，95％CI：0.23—0.79）。结论HLA-DQA1基因多态性影响HBV感染临床结局，其中DQA1＊0102呈保护作用，DQA1＊0201可能促进HBV感染的慢性化和肝炎的发生。

Objective To investigate the association between HLA-DQA1 gene polymorphism and the outcomes of hepatitis B virus infection in Chinese Han population. Methods A total of 180 consecutive patients with biopsy-proven hepatitis B virus infection （120 patients with chronic hepatitis B and 60 patients with asymptomatic HBV carrier） and 60 subjects who resolved from HBV infection spontaneously were studied. Genotype of human leukocyte antigen（ HLA）-DQA1 was detected by polymerase chain reaction sequence specific primer（PCR-SSP）.Results（1）The frequency of HLA-DQA1＊0201 allele in chronic hepatitis B group was significant higher than the frequency in resolved from HBV infection spontaneously group（38.3 % vs 5.8 %, P 〈 0.001, A = 10.04, 95% CI： 4.48-22.48） . The frequency of HLA-DQA1＊0102 allele in chronic hepatitis B group was significant lower than the frequency in resolved from HBV infection spontaneously group （9.6% vs 36.7% ,P 〈 0.001, A = 0.183, 95% CI：0.10-0.32）. （2） The frequency of HLA-DQA1＊0201 allele in chronic hepatitis B group was significant higher than the frequency in asymptomatic HBV carrier group（38.3 % vs 7.5%, P 〈 0.01, A = 7.667,95% CI：3.7-15.87）. The frequency of HLA-DQA1 ＊0102 allele in chronic hepatitis B group was significant lower than the frequency in asymptomatic HBV carrier group（20% vs 9.6%, P 〈 0.O1,A = 0.424,95% CI：0.23-0.79）. Conclusion HLA-DQA1 gene polymorphism may play an important role in the outcomes of hepatitis B virus infection in Chinese Han population. The HLA-DQA1＊0102 allele could keep individuals away from HBV infection, and HLA-DQA1＊0201 allele could aggravate persistant infection of HBV and hepatic inflammatory.