Immunologic features and HLA associations in chronic viral hepatitis.
OBJECTIVE
Chronic viral hepatitis may have immunologic manifestations, and such features may reflect genetic predispositions. The aim of this study was to assess associations between immune manifestations and HLA-DR antigens.


METHODS
Ninety-five patients were evaluated prospectively for immunologic features. A microlymphocytotoxicity technique was used to determine DR3, DR4, and A1-B8-DR3 phenotypes. DR antigens were also determined by restriction fragment length polymorphism in 76 patients with chronic viral hepatitis and 80 normal subjects.


RESULTS
Autoantibodies were found in 59 patients (62%), and concurrent immunologic diseases were found in 22 patients (23%). Patients with antinuclear antibodies had the A1-B8-DR3 phenotype more commonly than seronegative counterparts (26% vs. 6%; P = 0.02) and had DR3 positivity more frequently than normal subjects (41% vs. 18%; P = 0.03). In contrast, patients with concurrent immunologic diseases had DR4 positivity more commonly than patients without these findings (68% vs. 27%; P = 0.001) and normal subjects (68% vs. 30%; P = 0.003).


CONCLUSIONS
Patients with chronic viral hepatitis commonly have autoantibodies and/or concurrent immunologic diseases. The expression of antinuclear antibodies is associated with the A1-B8-DR3 phenotype, and the presence of concurrent immunologic diseases is associated with the DR4 phenotype. In these instances, autoimmune expression may reflect a genetic predisposition that is facilitated by viral infection or is coincidental with it.
Czaja
A J
AJ
Division of Gastroenterology and Internal Medicine, Mayo Clinic, Rochester, Minnesota.
Carpenter
H A
HA
Santrach
P J
PJ
Moore
S B
SB
D015415:Biomarkers; D002908:Chronic Disease; D005260:Female; D006680:HLA Antigens / Q000032:analysis*; D015795:HLA-B8 Antigen / Q000032:analysis; D006684:HLA-DR Antigens / Q000032:analysis / Q000145:classification; D006525:Hepatitis, Viral, Human / Q000150:complications* / Q000276:immunology*; D006801:Humans; D007154:Immune System Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012150:Polymorphism, Restriction Fragment Length
D015415:Biomarkers; D006680:HLA Antigens; D015795:HLA-B8 Antigen; D006684:HLA-DR Antigens