Key result
The presence of HLA-DRw53 was strongly associated with rheumatic fever or rheumatic heart disease, occurring in 72.9% of patients versus 39% of healthy controls (RR 4.2; p=0.00061).
Why the study?
Are specific HLA antigens associated with rheumatic fever or rheumatic heart disease in a Brazilian population?
Case-Control (n=657)
Are specific HLA antigens associated with rheumatic fever or rheumatic heart disease in a Brazilian population?
Relative Risk: 4.2
Absolute Event Rate: 72.9% vs 39%
p-value: p=0.00061
HLA-DR7 and HLA-DRw53 are identified as genetic susceptibility markers for rheumatic fever and rheumatic heart disease in a Brazilian population.
Supports HLA-DRw53 as susceptibility marker in Brazilians; hypothesis-generating for risk stratification pending validation.
BACKGROUND: The incidence of rheumatic heart disease is great in Brazil. We analyzed the distribution of human leukocyte (HLA) antigens in a Brazilian population sample with rheumatic fever or rheumatic heart disease, with the aim of better understanding the mechanisms involved. METHODS AND RESULTS: HLA class I (A, B, and C) and class II (DR and DQ) antigen distribution was studied in 40 patients with diagnosis of rheumatic fever or rheumatic heart disease and compared with a control group of 617 healthy individuals for class I typing, from which 118 were drawn for class II typing. A strong correlation between rheumatic fever and rheumatic heart disease and HLA-DRw53 (72.9% in the disease group versus 39% in the control group: p = 0.00061, relative risk, 4.2; etiologic fraction, 0.43) was found. We also found an increase in the frequency of HLA-DR7 (57.5% in the disease group versus 26.3% in control group: p = 0.00715; relative risk, 3.8; etiologic fraction, 0.56). HLA class I and HLA-DQ typing did not point to any association with these diseases. CONCLUSIONS: HLA-DR7 and HLA-DRw53 are markers for susceptibility to rheumatic fever and rheumatic heart disease in Brazil. These results could be explained by genetic differences resulting from racial or geographical diversity.
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Guilherme et al. (1991) conducted a case-control in Rheumatic fever or rheumatic heart disease (n=657). HLA-DRw53 antigen vs. Healthy individuals was evaluated on Presence of HLA-DRw53 antigen (RR 4.2, p=0.00061). The presence of HLA-DRw53 was strongly associated with rheumatic fever or rheumatic heart disease, occurring in 72.9% of patients versus 39% of healthy controls (RR 4.2; p=0.00061).
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