Association between hepatitis B virus infection and HLA-DR type in Korea

Although the mechanism of susceptibility to chronic persistent hepatitis B virus (HBV) infection is not well clarified, immunogenetic factors of the host may have a role. Recently, a strong association between HLA-DR13 and the self-limited course of HBV infection has been reported. To determine whether the elimination of HBV is related to a particular HLA allele, we studied the HBV markers and HLA-DR phenotypes of 1,272 Koreans who had visited Yonsei University Medical Center for renal transplantation. They included 330 renal transplant donors. Subjects were categorized into 3 different groups: the 'Unexposed Group' (UE; n = 946) with negative HBV markers, the 'Chronic Carrier Group' (CC; n = 83), who were hepatitis B surface antigen (HBsAg)- positive, and the 'Spontaneously Cleared Group' (SC; n = 243), who were HBsAg-negative with antibodies to HBsAg (anti-HBs) and hepatitis B core antigen (anti-HBc). HLA-DR4 was the most common type in all groups. HLA-DR6 was significantly more frequent in 69 of 243 subjects with SC (28.4%) than in 8 of 83 subjects with CC (9.6%) (P<.001; relative risk [RR] = 3.72). HLA-DR9 was significantly more frequent in CC than in SC (P < .001; RR = 0.33). HLA- DR13 showed a stronger association with the clearance of HBV than the other HLA-DR6 subgroup. The distribution of HLA-DR phenotypes was similar regardless of renal disease. Our data indicate that HLA-DR6, especially HLA- DR13, is one of the host factors, which influences the immune response to HBV, and may be associated with self-elimination of HBV in Koreans.