IMMUNE PHENOTYPE OF CHRONIC LIVER-DISEASE

Immune disorders in chronic liver disease may reflect common host prop ensities or disease-specific factors. Our aim was to determine the pri ncipal bases for these expressions. Four hundred fifty-one patients wi th various chronic liver diseases were assessed prospectively for conc urrent immune disorders. Individuals with immune diseases were more fr equently women (73% vs 60%, P = 0.02) and they had HLA DR4 more often than counterparts with other HLA (46% vs 23%, P = 0.000008). The assoc iation between HLA DR4 and immune disease was apparent within individu al liver diseases and within different categories of liver disease. Wo men with HLA DR4 had a higher frequency of immune disease than women w ithout HLA DR4 (52% vs 22%, P less than or equal to 0.000001), and the y also had immune diseases more commonly than DR4-positive men (52% vs 31%, P = 0.03). DR4-positive men, however, had higher frequencies of immune disease than DR4-negative men, especially in the nonimmune type s of liver disease (26% vs 4%, P = 0.002). We conclude that HLA DR4 an d female gender constitute an immune phenotype that is an important ba sis for autoimmune expression in chronic liver disease.