title: Association of HLA genes with clinical outcomes of ANCA-associated vasculitis.
abstract: OBJECTIVE
  The HLA system plays a central role in the distinction between self antigens and non-self antigens. This study aimed to investigate the association between HLA genes and the outcomes of patients with ANCA-associated vasculitis (AAV).
  
  
  METHODS
  This study recruited 152 consecutive Chinese patients with AAV. The predictive value of the HLA alleles for renal outcome, response to treatment, and all-cause mortality were analyzed.
  
  
  RESULTS
  The proportion of patients with treatment failure was significantly higher in DRB1*0405-positive patients than in DRB1*0405-negative patients (41.7% versus 12.9%; P=0.008; corrected P=0.02). After adjusting for the other potential predictors, DRB1*0405 was still an independent predictor for the poor response to treatment (hazard ratio [HR], 5.91; 95% confidence interval [95% CI], 1.23-28.52; P=0.03). Renal survival was significantly worse in patients with DRB1*0405 than those without DRB1*0405 (P<0.001; corrected P<0.001). After adjusting for the other potential predictors, DRB1*0405 was still an independent predictor for ESRD (HR, 5.50; 95% CI, 2.18-13.88; P<0.001). The probability of all-cause mortality in patients with DPB1*0402 was significantly higher than those without DPB1*0402 (P=0.02; corrected P=0.04). After adjusting for the other potential predictors, DPB1*0402 was still an independent predictor for all-cause mortality (HR, 2.52; 95% CI, 1.21-5.28; P=0.01).
  
  
  CONCLUSIONS
  In AAV patients, DRB1*0405 might be an independent risk factor for the poor response to treatment and the deterioration of renal function, whereas DPB1*0402 might be an independent risk factor for all-cause mortality.
authors.affiliation: Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Key Laboratory of Renal Disease, Ministry of Health of China, and Key Laboratory of CKD Prevention and Treatment, Ministry of Education of China, Beijing, China.
authors.forename: Dong-yuan
authors.initials: DY
authors.lastname: Chang
authors.forename: Huan
authors.initials: H
authors.lastname: Luo
authors.forename: Xu-jie
authors.initials: XJ
authors.lastname: Zhou
authors.forename: Min
authors.initials: M
authors.lastname: Chen
authors.forename: Ming-Hui
authors.initials: MH
authors.lastname: Zhao
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000235:genetics* / Q000276:immunology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D016009:Chi-Square Distribution; D002681:China; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D005787:Gene Frequency; D020022:Genetic Predisposition to Disease; D059868:HLA-DP beta-Chains / Q000235:genetics; D015798:HLA-DR1 Antigen / Q000235:genetics*; D059811:HLA-DRB1 Chains / Q000235:genetics; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000235:genetics* / Q000276:immunology / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010641:Phenotype; D010951:Plasma Exchange; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D059868:HLA-DP beta-Chains; C505114:HLA-DPB1*04:02 antigen; D015798:HLA-DR1 Antigen; D059811:HLA-DRB1 Chains; C493960:HLA-DRB1*04:05 antigen; D007166:Immunosuppressive Agents