ASSOCIATIONS BETWEEN ALLELES OF THE MAJOR HISTOCOMPATIBILITY COMPLEX AND TYPE-1 AUTOIMMUNE HEPATITIS

Susceptibility for type 1 autoimmune hepatitis has been associated wit h the major histocompatibility alleles DRB10301, DRB3*0101, DRB1*0401 , and DRB40103, whereas the DRB1*1501 allele may protect from the dis ease, Our aim was to determine if these alleles or others influence cl inical manifestations and prognosis, Eighty-six white patients were ev aluated prospectively for immune features and outcomes, Class I allele s were determined by microlymphocytotoxicity, and class II alleles wer e assessed by polymerase chain reaction with sequence-specific oligonu cleotide probes or sequence-specific primers, One hundred two white, n ormal subjects were typed in the same fashion, Patients with concurren t immunologic diseases were more commonly positive for DRB40103 than patients without these features (68% vs, 38%, P = .01), DRB10301 (86% vs, 45%, P = .008) and the DRB10301-DRB3*0101 haplotype (79% vs, 42% , P = .02) occurred more commonly in patients who deteriorated during corticosteroid therapy, In contrast, DRB10401 and the DRB1*0401-DRB4* 0103 haplotype were associated with a lower frequency of death from li ver failure or the need for transplantation than patients with other a lleles (0% vs, 37%, P = .03), Patients with DRB10301 differed from th ose with DRB10401 in that they were younger and failed treatment more commonly (27% vs, 5%, P = .04), We conclude that alleles associated w ith susceptibility to type 1 autoimmune hepatitis also influence its c linical features and prognosis, DRB40103 is associated with concurren t immune diseases, DRB10301 with a poor treatment response, and DRB1* 0401 with a lower frequency of hepatic death or transplantation.