MHC class I and class II genes in mexican patients with Chagas disease

Chagas' disease contributes significantly to cardiovascular morbidity and mortality in several Latin-American countries. Previous studies have reported the effect of the human leukocyte antigen (HLA) molecules in the immune response regulation of Trypanosoma cruzi infection, and the association of HLA antigens with heart damage. We studied the major histocompatibility complex (MHC) class I (HLA-A and HLA-B), and class II (HLA-DR) genes in a sample of 66 serologically positive individuals with and without cardiomyopathy, and in 127 healthy controls. The total group of seropositive individuals revealed increased frequencies of HLA-B39 ( p c = 4.3×10 −5, odds ratio [OR] = 3.35) and DR4 ( p c = 1.8×10 −5, OR = 2.91) when compared to healthy controls. Increased frequencies of HLA-A68 and HLA-B39 were found in asymptomatic individuals when compared to patients with cardiomyopathy ( p c = 0.014, OR = 4.99 and p c = 0.001, OR = 4.46, respectively). Also, patients with cardiomyopathy exhibited increased frequency of HLA-B35 when compared to healthy controls ( p c = 0.048, OR = 2.56). The HLA-DR16 frequency was increased in patients with cardiomyopathy compared with asymptomatic individuals ( p c = 0.05, OR = No determined) and healthy controls ( p c = 0.02, OR = 5.0). The results suggest that MHC alleles might be associated with the development of chronic infection and with heart damage in Chagas' disease. HLA-DR4 and HLA-B39 could be associated directly with the infection by T. cruzi, whereas, HLA-DR16 could be marker of susceptibility to heart damage and HLA-A68 might confer protection to develop cardiomyopathy.