title: HLA-DRB1*01 allele and low plasma immunoglobulin G1 concentration may predispose to herpes-associated recurrent lymphocytic meningitis.
abstract: Recurrent lymphocytic meningitis (RLM) is a rare illness caused mostly by herpes simplex virus type 2 (HSV-2). Predisposing factors are not known. Deficiencies in immunoglobulin (Ig) G subclasses 1 (IgG1) and 3 (IgG3) and complement protein C4 are associated with susceptibility to and persistence of bacterial and viral infections. Selected HLA and mannose-binding lectin (MBL) alleles have previously been associated with recurrent genital herpes or herpetic meningitis. We assessed the frequencies of low IgG1 and IgG3, their allotypes (Gm), and HLA-A*, -B*, -DRB1*, and MBL2 alleles, as well as deficiencies in C4A and C4B genes, as potential predisposing factors for HSV-2-associated RLM. The level of IgG1 was lower (p = 0.009) and the frequency of low IgG1 was higher (p < 0.001) in patients than in controls. Furthermore, the risk for a new meningitis episode was increased in patients with low IgG1 (incident ratio 2.05). HLA-DRB1*01 (p = 0.009) and -B*27 (p = 0.050) were more common among patients than controls. We conclude that HLA-DRB1*01 and -B*27 alleles and low plasma IgG1 levels may be significant risk factors for RLM.
authors.affiliation: Pain Clinic, Department of Anaesthesiology and Intensive Care Medicine, Helsinki University Central Hospital, Helsinki, Finland. katariina.kallio-laine@helsinki.fi
authors.forename: Katariina
authors.initials: K
authors.lastname: Kallio-Laine
authors.forename: Mikko
authors.initials: M
authors.lastname: Seppänen
authors.forename: Janne
authors.initials: J
authors.lastname: Aittoniemi
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.forename: Ilkka
authors.initials: I
authors.lastname: Seppälä
authors.forename: Ville
authors.initials: V
authors.lastname: Valtonen
authors.forename: Markus
authors.initials: M
authors.lastname: Färkkilä
authors.forename: Eija
authors.initials: E
authors.lastname: Kalso
authors.forename: Marja-Liisa
authors.initials: ML
authors.lastname: Lokki
mesh_terms: D000328:Adult; D000483:Alleles; D003181:Complement C4 / Q000172:deficiency / Q000235:genetics; D004198:Disease Susceptibility; D020803:Encephalitis, Herpes Simplex / Q000097:blood* / Q000235:genetics*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D020022:Genetic Predisposition to Disease; D015235:HLA-B Antigens / Q000235:genetics; D006684:HLA-DR Antigens / Q000235:genetics*; D059811:HLA-DRB1 Chains; D018258:Herpesvirus 2, Human / Q000276:immunology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors
chemical_list: D003181:Complement C4; D015235:HLA-B Antigens; D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains; C497841:HLA-DRB1*01 antigen; D007074:Immunoglobulin G