title: Human leukocyte antigen class II DQ alleles associated with Chlamydia trachomatis tubal infertility.
abstract: OBJECTIVE
  To investigate epidemiologic tubal infertility risk factors and the relationship between HLA class II alleles and Chlamydia trachomatis tubal infertility.
  
  
  METHODS
  Forty-seven women with tubal infertility and 46 fertile controls were studied in Nairobi, Kenya. A questionnaire was administered and serum collected for measurement of C trachomatis antibodies. HLA class II molecular typing was done with DNA extracted from peripheral blood lymphocytes. The prevalence of C trachomatis microimmunofluorescence antibody, chlamydia heat shock protein 60 antibody, and HLA class II alleles was compared among cases of tubal infertility and fertile controls.
  
  
  RESULTS
  Women with tubal infertility more often had histories of pelvic inflammatory disease (15% versus 0%; odds ratio [OR] 16; 95% confidence interval [CI] 5.5, 47) histories of spontaneous abortion (34% versus 7%; OR 6.7; 95% CI 2.8, 16), and antibodies to C trachomatis (53% versus 26%; OR 3.2; 95% CI 1.3, 7.7) than controls. Among infertile women, DQA*0101 and DQB*0501 alleles were positively associated with C trachomatis tubal infertility (OR 4.9; 95% CI 1.3, 18.6, and OR 6.8; 95% CI 1.6, 29.2, respectively). DQA*0102 was negatively associated with C trachomatis tubal infertility (OR 0.2; 95% CI 0.005, 0.6).
  
  
  CONCLUSIONS
  Chlamydia trachomatis infection is an important cause of tubal infertility in Nairobi. The association of specific HLA class II alleles with C trachomatis microimmunofluorescence seropositivity among women with tubal infertility suggests that the DQ locus might modify susceptibility to and pathogenicity of C trachomatis infection.
authors.affiliation: Department of Obstetrics and Gynecology, University of Washington, Seattle 98104-6460, USA. crcohen@u.washington.edu
authors.forename: C R
authors.initials: CR
authors.lastname: Cohen
authors.forename: S S
authors.initials: SS
authors.lastname: Sinei
authors.forename: E A
authors.initials: EA
authors.lastname: Bukusi
authors.forename: J J
authors.initials: JJ
authors.lastname: Bwayo
authors.forename: K K
authors.initials: KK
authors.lastname: Holmes
authors.forename: R C
authors.initials: RC
authors.lastname: Brunham
mesh_terms: D000328:Adult; D000483:Alleles; D002690:Chlamydia Infections / Q000276:immunology*; D002692:Chlamydia trachomatis; D004198:Disease Susceptibility; D005260:Female; D005455:Fluorescent Antibody Technique; D006683:HLA-DQ Antigens / Q000235:genetics*; D006801:Humans; D007247:Infertility, Female / Q000382:microbiology*; D007630:Kenya; D012725:Sexual Behavior
chemical_list: D006683:HLA-DQ Antigens