Association of HLA Alleles with Hepatitis C Infection in Maharashtra, Western India (Human Leukocyte Antigen) (Report‪)‬

Hepatitis C virus (HCV) is an important blood-borne pathogen that is eliminated from the host in approximately 15 per cent of acutely infected individuals but persists in the remaining 85 per cent (1) HCV is responsible for a wide spectrum of chronic liver lesions ranging from minimal to cirrhosis or hepatocellular carcinoma (HCC) and fatal outcome (2,3). Both virus-related factors such as viral heterogeneity and replicative activity (4) and the host determinants such as lack of efficient immune responses (5) are involved in the pathogenesis of chronic hepatitis. Further the liver damage in HCV infected patients is probably associated with direct cytopathic effects and immune mediated mechanisms (6). Though the exact basis for the differential clinical presentation of HCV infection is not fully understood, viral load and genotype (7) have been reported to influence the prognosis. The observation of different clinical presentations despite the same source of infection led to the recognition of the importance of host genetic factors in disease manifestations (8). In an Irish Cohort, of the 704 women infected with HCV from contaminated anti-D immune globulin, 390 (55%) became persistently infected (9). MHC class I and class II antigens are central to the host immune response and thus are ideal candidate genes to investigate for associations with HCV. Class I and Class II HLA are encoded by the most polymorphic genes that present antigens to CD8+ cytotoxic T cells and CD4+ helper T cells respectively. Polymorphisms in binding regions of these molecules determine antigenic specificities and the strength of the immune response to a given pathogen. Moreover during cellular immune response, HLA class I molecules may present HCV epitopes to cytotoxic T cells, resulting in a protective immune response. The human leukocyte antigen is a crucial genetic factor that initiates and regulates immune responses by presenting foreign or self-antigens to T lymphocytes. Certain HLA alleles have been shown to influence the outcome of chronic HCV infections (10,11). Various HLA alleles have been linked with either persistence or clearance of the virus. Several studies have aimed to identify the involvement of HLA with different outcomes of HCV infection, but the results have not been consistent. Moreover literature review revealed that the prevalence of HCV infection is significantly low in Indian population (12-14). So far, no data on HLA association with HCV infection have been reported from western India. Therefore, this study was undertaken to find out whether there is any genetic basis that involves HLA with HCV infection among anti-HCV positive individuals from the state of Maharashtra, western India. Material & Methods