HLA B subtype analysis in patients developing tuberculosis during anti-TNF treatment

Area of Science:

• Immunogenetics
• Rheumatology
• Infectious Diseases

Background:

• Anti-tumor necrosis factor (anti-TNF) therapies are crucial for managing autoimmune diseases.
• Patients on anti-TNF agents may have altered susceptibility to infections, including tuberculosis (TB).
• Human Leukocyte Antigen B (HLA-B) subtypes are known to influence immune responses and disease susceptibility.

Purpose of the Study:

• To evaluate HLA-B subtypes in patients who developed TB while on anti-TNF therapy.
• To compare these HLA-B subtypes with those in community-acquired TB patients, anti-TNF patients without TB, and healthy controls.

Main Methods:

• Genetic analysis of HLA-B subtypes from blood samples of four distinct groups.
• Utilized the LIFECODES HLA-B eRES SSO Typing kit for HLA-B typing.
• Included 35 community-acquired TB patients, 47 anti-TNF-TB patients, 61 anti-TNF (non-TB) patients, and 40 healthy controls.

Main Results:

• Significant differences in HLA-B subtypes were observed for HLA-B5, HLA-B8, HLA-B27, and HLA-B38 across the four groups.
• HLA-B8 frequency was highest in anti-TNF patients who developed TB, but this did not reach statistical significance after correction.
• HLA-B27 was elevated in both anti-TNF groups, attributed to patients with ankylosing spondylitis.

Conclusions:

• This is the first study to analyze HLA-B subtypes in anti-TNF patients developing TB.
• The study did not confirm a previously suggested association between HLA-B8 and community-acquired TB in the context of anti-TNF therapy.
• Larger, multi-ethnic studies are required to definitively establish HLA-B subtype associations in this patient population.