The relationship between HLA-DRB1 types and chrocical hepatitis C enfection

Introduction: Hepatitis C virus (HCV) causes a very chronic infection. It is an important public health problem as responsible for an estimated 350.000 deaths annually in global scale. Recently, the factors involved in the prognosis of disease are became a major area of interest. It was reported that human leukocyte antigen (HLA) allele polymorphism has effects to the prognosis of the disease caused by HCV. The purpose of the present study was to investigate the effects of HLA DR B1 alleles to both therapy response and the prognosis of the infection. Materials and Methods: A total of 65 chronically HCV patients, under follow up between February 2014 and January 2015 in Adnan Menderes University, Research and Training Hospital, were included in the study. The prognosis of patients included in the study was determined by using patients' HCV-RNA data. In this regard, the patients divided into three groups: spontaneous viral clearance (patients who had a decrease of ≥ 2 log10 at viral load without any treatment during controls performed every six months), responded to treatment (patients who had a decrease of ≥ 2 log10 at viral load in 24th and 48 th week after treatment and during controls performed every six months) and relapses/non-response to treatment (patients who had no decrease of ≥ 2 log10 at viral load in 24th and 48th week after treatment and during controls performed every six months; or had a decrease at viral load but increased again during controls performed every six months). In order to determine HLA DR-B1 alleles, total genomic DNA was extracted from whole blood samples collected from patients in EDTA containing tubes. DNA isolation was performed with spin column method by using commercial kits and HLA DRB1 alleles were detected with Sequence Specific Oligonucleotide Probes (SSO)-luminex by using LIFECODES HLA-DRB1 eRES Typing Kit (ImmucorTransplantDiagnostics, Stamford, USA). Statistical Package for the SocialSciences (SPSS) version23.0wasusedforstatisticalanalysis. The categorical variables were compared with chi-square test. Results: In the present study 36 out of 65 HCV patients (55,4%) were responded to treatment, 16 (24,6%) had relapses and/or no response to treatment and 13 (20%) were the patients with spontaneous viral clearance. The ages of patients were changing from 22 to 79, with a mean 56,5±12,9. Of the patients 28 (43,1%) were male and 37 (56,9%) were female. 52 The distribution of genotypes were as follows: genotype 1 (61 patients ) 93,6 %, genotype 2 (one patient) 1,6%, genotype 3 (one patient) 1,6%, genotype 4 (two patient) 3,2%. The frequency of patients' HLA-DRB1 alleles were as follows: 34 were (26,15%) *11, 20 were (15,38%)*4, 14 were (10,17%) *15, 13 were (10%) *13, 11 were (8,46%) *1, 7 were (5,38%) *3, six patients (4,61%) with each of alleles *10, 14, 16, five patients (3,84%) with both alleles *7 and *8. HLA-DRB1*2, 5, 6, 12 alleles were not detected. HLADRB1*11 allele was the most common among the patients with spontaneous viral clearance or with treatment response, HLA-DRB1*13 allele was the most common among the patients with no treatment response or relapse. HLA-DRB1*13 allele was statistically associated was with the disease prognosis and also HLA-DRB1*13 treatment response (p< 0,002). Conclusion: In the light of the recent findings, we have concluded that having HLA-DRB1*13 allele may be a candidate risk factor for the disease prognosis and treatment response. Therefore, in order to schedule an effective treatment option for HCV infected patients, the detection HLA-DRB1 alleles of patients may be necessary and/or functional.