[Clinical significance of HLA phenotype in childhood tuberculosis]

According to HLA system (loci A, B, C, DR), examination findings of 171 children aged between 1 and 15 years with different clinical manifestations of primary tuberculosis (including 49 with a pulmonary type of tuberculosis in different stages of inflammation, 46 with osteoarticular lesions of tuberculous etiology and 76 with generalized forms of tuberculosis) indicate a significant rise in the incidence of HLA-B7, B14 antigens. Moreover, the incidence of HLA-B14 antigen increases sharply as the degree of clinical manifestations and severity of inflammatory changes become more evident. In intrathoracic adenopathy, the presence of HLA-DR, DR2 antigens seems to promote earlier clinico-roentgenologic manifestations and a more serious course of an inflammatory process. In combined osteoarticular processes of specific etiology, an increase in the incidence of HLA-DR5, DR7 antigens is significant. The most evident drop in the immune T-system indices is traced in subjects bearing HLA-DR2 antigen. The given fact makes it possible to proceed on the assumption that genetically controlled immune response factors play a certain role in pathogenesis of tuberculosis.