title: The potential usefulness of human leukocyte antigen typing for celiac disease screening: A systematic review and meta-analysis.
abstract: OBJECTIVE
  The presence of specific human leukocyte antigen-DQ2 and DQ8 seems to be necessary for celiac disease development, but the real contribution of its typing for screening is still uncertain. We aim to conduct a systematic review and meta-analysis of the diagnostic performance of human leukocyte antigen typing tests for celiac disease screening.
  
  
  METHODS
  Systematic review of published studies assessing accuracy of human leukocyte antigen DQ2 and DQ8 typing for the detection of celiac disease were selected. MEDLINE and EMBASE were searched from 1st January 2004 until 31st December 2013. Two independent researchers carried out selection and classification of studies, data extraction and analysis. Meta-analysis combining sensitivities, specificities and likelihood ratios of HLA-DQ2 and DQ8 for the diagnosis of celiac disease were carried out.
  
  
  RESULTS
  6 studies including 1303 individuals were finally evaluated. Pooled sensitivity was 98% (95% confidence interval: 97-99). Overall specificity was 45% (95% confidence interval: 41-48). Regarding specificity, studies were heterogeneous and a subgroup analysis was done according to the type of population included. Overall negative likelihood ratio was 0.05 (0.03-0.09).
  
  
  CONCLUSIONS
  Due to its great sensitivity and low negative likelihood ratio, human leukocyte antigen-DQ2/DQ8 typing would be an appropriate test for ruling out celiac disease in the general population suffering related symptoms, and even more in at risk population.
authors.forename: Alicia
authors.initials: A
authors.lastname: Díaz-Redondo
authors.forename: José
authors.initials: J
authors.lastname: Miranda-Bautista
authors.forename: Javier
authors.initials: J
authors.lastname: García-Lledó
authors.forename: Javier P
authors.initials: JP
authors.lastname: Gisbert
authors.forename: Luis
authors.initials: L
authors.lastname: Menchén
mesh_terms: D015415:Biomarkers / Q000097:blood; D002446:Celiac Disease / Q000097:blood / Q000175:diagnosis* / Q000276:immunology; D006683:HLA-DQ Antigens / Q000097:blood*; D006801:Humans; D015233:Models, Statistical; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D006683:HLA-DQ Antigens; C053186:HLA-DQ2 antigen; C109756:HLA-DQ8 antigen