HLA DRB1 Alleles Discriminate the Manifestation of Autoimmune Hepatitis as Type 1 or Type 2 in North Indian Population

Navchetan Kaur; Ranjana W Minz; Shashi Anand; Biman Saikia; Ritu Aggarwal; Ashim Das; Babu R Thapa; Yogesh K Chawla

doi:10.1016/j.jceh.2013.12.002

HLA DRB1 Alleles Discriminate the Manifestation of Autoimmune Hepatitis as Type 1 or Type 2 in North Indian Population

J Clin Exp Hepatol. 2014 Mar;4(1):14-8. doi: 10.1016/j.jceh.2013.12.002. Epub 2013 Dec 16.

Authors

Navchetan Kaur¹, Ranjana W Minz¹, Shashi Anand¹, Biman Saikia¹, Ritu Aggarwal¹, Ashim Das², Babu R Thapa³, Yogesh K Chawla⁴

Affiliations

¹ Department of Immunopathology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
² Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
³ Department of Paediatric Gastroenterology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
⁴ Department of Hepatology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.

Abstract

Background: Autoimmune hepatitis is a polygenic disorder of unknown etiology, where genetic factors affect the occurrence and clinical phenotype of the disease. It has been reported as a rare disease entity in the Indian subcontinent. This study was undertaken to investigate the association of HLA alleles with autoimmune hepatitis type 1 and type 2 in north Indian population and to analyze if distinct human leukocyte antigen (HLA) alleles help in characterization of the subtypes of autoimmune hepatitis.

Methods: Sixty-eight patients with autoimmune hepatitis and 128 healthy controls were recruited in the study. Out of 68 patients, 55 were diagnosed with autoimmune hepatitis type 1 and 13 with autoimmune hepatitis type 2. The patients and the controls were typed for HLA class II alleles by PCR-SSP method.

Results: HLA DRB1*04 and DRB1*08 were found to be significantly associated with autoimmune hepatitis type 1 in north Indian population. It was also observed that DRB1*04, DRB1*13 were significantly associated with pediatric autoimmune hepatitis type 1 and DRB1*08 was significantly associated with adult autoimmune hepatitis type 1. DRB1*14 was significantly associated with autoimmune hepatitis type 2.

Conclusion: The study indicates that autoimmune hepatitis in north Indian population is associated with HLA alleles that may help to discriminate the subtypes as autoimmune hepatitis type 1 and type 2. The study also highlights the ethnic variations in the Indian subcontinent in context to the genetic association of HLA with autoimmune diseases.

Keywords: AASLD, American Association for the Study of the Liver; AIH, autoimmune hepatitis; ANA, antinuclear antibody; ASMA, anti smooth muscle antibody; CI, confidence interval; HLA, human leukocyte antigen; IAHG, International Autoimmune Hepatitis Group; IIF, indirect immuno florescence; LKM, liver kidney microsomal; MHC, major histocompatibility complex; Mb, megabase; OR, odds ratio; PCR-SSP, polymerase chain reaction-sequence specific primers; RR, relative risk; autoimmune hepatitis; ethnic variations; human leukocyte antigen; north India.