Association Of HLA - DRB1 Gene Polymorphism With Different Clinical Outcomes Of Traditional Chinese Medicine And HBV Infection

Objectives:1.TO investigate the association between the type of TCM constitution and theoutcomes of HBV infection.2.TO investigate the association between the polymorphism of HLA-DRB1and theoutcomes of HBV infection.Materials and methods:122patients with chronic hepatitis B,122patients with asymptomatic HBsAgcarriers and sixty-one self-limited HBV infection persons were included in thisstudy.All the patients were from the Department of Infectious Diseases,Affiliated Hospital of Liaoning University of Traditional Chinese Medicine.Thediagnosis of all the cases was made according to the criteria established onthe Viral Hepatitis Conference held in2000.The subjects were divided intochronic hepatitis B(CHB) group, asymptomatic HBsAg carriers(ASC) group andelf-limited HBV infection(SHB) group.1. Clinical epidemiology survey methods: Take WANG Qi’s measurementquestionnaire of constitution to survey the TCM constitution of all subjects,and record the general subjects including age, gender, occupation, place oforigin and time of onset, course of treatment,ect. Compared the distributionof TCM constitution in each group.2. Laboratory research methods: HLA-DRB1alleles in forty subjects each groupwere analyzed by using the PCR-SSOP technique combined with Flow PRATMbeadstechnique. Compared the distribution of HLA-DRB1alleles in each group. Results:1. The distribution of TCM constitution type in the group of CHB, ASC and RHBSwas different.The difference among the three groups was significant (P＜0.05).2. The type frequency of gentleness constitution in ASC group was markedly higherthan that in CHB group(41.0%VS9.8%),there was a significant correlation betweenthem(X2=31.224，P=0.000,OR=0.157); the type frequency of dampness-heatconstitution in ASC group was lower than that in CHB group(6.6%VS25.4%), therewas a significant correlation between them(X2=16.145，P=0.000，OR=4.854).3. The type frequency of yin deficiency constitution and phlegm constitutionin SHB group were markedly lower than that in CHB group(4.9%VS20.5%and4.9%VS12.3%), there was a significant correlation between them (P=0.000,OR=10.223；P=0.006,OR=15.561).4. The type frequency of qi deficiency constitution and yin deficiencyconstitution in SHB group were markedly lower than that in ASC group(3.3%VS13.1%、4.9%VS13.1%), there was a significant correlation between them(P=0.001,OR=9.057；P=0.003,OR=5.987).5. The distribution of HLA-DRB1alleles among the groups of CHB, ASC and SHBgroup were different. The difference among the three groups was significant (P<0.05).6. The allele frequency of HLA-DRB1*07, HLA-DRB1*11s in SHB group were wasmarkedly lower than that in CHB group(1.2%VS18.8%、2.5%VS16.2%), therewas a significant correlation between them(P=0.000,OR=18.231；P=0.005,OR=7.567);the allele frequency of HLA-DRB1*12in SHB group was markedly higher than thatin CHB group(27.5%VS10.0%), there was a significant correlation betweenthem(X2=8.041, P=0.005,OR=0.293).Conclusions:1. The factor of TCM constitution is related with the different outcomes of HBVinfection, it can affect the clinical outcomes of HBV infection. ⑴Both qi deficiency constitution and yin deficiency constitution in normalpeople who infected HBV may be more susceptible to becoming ASC, but thepossibility of Qi deficiency constitution is higher.⑵Both yin deficiency constitution and phlegm constitution in normal peoplewho infected HBV may be more susceptible to becoming CHB, but the possibilityof yin deficiency constitution is higher.⑶Dampness-heat constitution in ASC may be more susceptible to becoming CHB,gentleness constitution in ASC may be easier to maintain the state of viruscarrier in a long term.2. The polymorphism of HLA-DRB1genes is related with the different outcomesof HBV infection,it can affect the clinical outcomes of HBV infection.⑴HLA-DRB1*07, HLA-DRB1*11alleles may be susceptible genes of CHB.⑵HLA-DRB1*12allele may be resistant gene of CHB.