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HLA associations with rheumatoid arthritis in African blacks

G M Mody1, M G Hammond, P D Naidoo

  • 1Department to Medicine, University of Natal, Durban, South Africa.

The Journal of Rheumatology
|October 1, 1989
PubMed

Insights

This study found a strong link between HLA-DR4 and rheumatoid arthritis (RA) in Black South Africans. HLA-B8 was also unexpectedly more common in RA patients, suggesting complex genetic factors in rheumatoid arthritis.

Area of Science:

  • Immunogenetics
  • Rheumatology
  • Human Leukocyte Antigens (HLA)

Background:

  • Rheumatoid arthritis (RA) is a chronic autoimmune disease with complex genetic underpinnings.
  • Human Leukocyte Antigen (HLA) genes are known to influence susceptibility to autoimmune diseases.
  • Previous research has indicated associations between specific HLA antigens and RA in various populations.

Purpose of the Study:

  • To investigate the association of HLA-A, B, C, and DR antigens with rheumatoid arthritis in a Black South African population.
  • To determine the frequency of HLA-DR4 and HLA-B8 in Black South African patients with RA.
  • To explore potential genetic factors contributing to RA pathogenesis in this specific demographic.

Main Methods:

  • HLA antigen typing (HLA-A, B, C, DR, and DQ) was performed on 100 Black South African patients diagnosed with classical or definite RA.
  • A control group was used for comparison of antigen frequencies.
  • Statistical analysis, including chi-squared tests and relative risk calculations, was employed to assess associations.

Main Results:

  • A highly significant association was found between HLA-DR4 and RA (p < 0.0001), with a frequency of 44% in RA patients versus 10% in controls (relative risk 7.4).
  • An unusual and significant increase in HLA-B8 frequency was observed in RA patients (35%) compared to controls (12.5%) (p < 0.001; relative risk 3.8).
  • No linkage disequilibrium was detected between HLA-DR4 and HLA-B8, indicating independent associations.

Conclusions:

  • HLA-DR4 is strongly associated with rheumatoid arthritis in Black South Africans, reinforcing its role as a major genetic risk factor.
  • The increased frequency of HLA-B8 in RA patients is an unexpected finding in this population, suggesting a potential independent genetic contribution.
  • These findings highlight the importance of population-specific genetic analyses in understanding the complex etiology of rheumatoid arthritis.

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