Relationship of HLA-DRB1 gene polymorphism with susceptibility to pulmonary tuberculosis: updated meta-analysis

BACKGROUND: Studies indicate that human leukocyte antigen (HLA) gene polymorphisms are implicated in the risk of pulmonary tuberculosis (PTB). However, research findings are contradictory. OBJECTIVE: To examine the association between HLA-DRB1 alleles and PTB risk using a meta-analysis on case-control studies. METHODS: We searched for relevant studies in the Pub Med and EMBASE databases. We used fixed-effects or random-effects models and reported combined odds ratios (ORs) and 95% confidence intervals (CI). The Newcastle-Ottawa Scale (NOS) was used to estimate the quality of each case-control study. RESULTS: A total of 21 individual case-control studies were identified, including studies of 14 family alleles and 28 specific alleles. Compared with controls, DRB1*15 and DRB1*08:03 were found to have significantly higher frequencies in PTB patients; however, DRB1*03, DRB1*11, DRB1*11:03 and DRB1*12:02 had significantly lower frequencies in the total population. The association between other HLA-DRB1 family alleles and specific alleles and predisposition to PTB was not statistically significant. Among Asian populations, DRB1*03 and DRB1*07:01 were associated with a reduced incidence of PTB, while DRB1*15 and DRB1*08:03 were associated with an increased incidence of PTB. CONCLUSION: We conclude that HLA-DRB1 may be a valuable marker to predict the risk for PTB, especially in Asian populations.