Relationship between HLA-DR gene polymorphisms and outcomes of hepatitis B viral infections：A meta-analysis

AIM：To assess the rigorous relationship between human leukocyte antigens（HLA）-DR alleles and outcomes of hepatitis B virus（HBV） infections by means of metaanalysis.METHODS：Medline/PubMed,EMBASE,CNKI and VIP were searched to identify relevant studies.Study quality was evaluated using the Newcastle-Ottawa Scale.Odds ratios（OR） and 95% confidence interval（95% CI） were pooled using Stata 11.0.Subgroup analyses were performed by ethnicity.Heterogeneity and publication bias analyses were performed to validate the credibility.RESULTS：A total of 2609 patients with chronic hepatitis B and 2606 controls spontaneously recovering from prior HBV infection were included.Meta-analysis showed that HLA-DR＊04（OR = 0.72,95% CI：0.60-0.85） and DR＊13（OR = 0.27,95% CI：0.19-0.37） alleles were significantly associated with HBV clearance while patients carrying HLA-DR＊03（OR = 1.47,95% CI：1.16-1.87） or DR＊07（OR = 1.59,95% CI：1.24-2.03） alleles had a significantly increased risk of chronic HBV persistence.For the HLA-DR＊01 polymorphism,a significantly association with HBV clearance was found in Chinese Han group（OR = 0.48,95% CI：0.26-0.86）,but not found in other ethnic groups（P = 0.191）.For other polymorphisms,no association with the HBV infection outcome was found.CONCLUSION：HLA-DR＊04 and DR＊13 alleles may be the protective factors for HBV clearance and HLADR＊03,and DR＊07 alleles may be the risk factors for HBV persistence.