Variation at HLA-DRB1 is associated with resistance to enteric fever.
Authors:
Dunstan, Sarah J Hue, Nguyen Thi Han, Buhm Li, Zheng Tram, Trinh Thi Bich Sim, Kar Seng Parry, Christopher M Chinh, Nguyen Tran Vinh, Ha Lan, Nguyen Phu Huong Thieu, Nga Tran Vu Vinh, Phat Voong Koirala, Samir Dongol, Sabina Arjyal, Amit Karkey, Abhilasha Shilpakar, Olita Dolecek, Christiane Foo, Jia Nee Phuong, Le Thi Lanh, Mai Ngoc Do, Tan Aung, Tin Hon, Do Nu Teo, Yik Ying Hibberd, Martin L Anders, Katherine L Okada, Yukinori Raychaudhuri, Soumya Simmons, Cameron P Baker, Stephen de Bakker, Paul I W Basnyat, Buddha Hien, Tran Tinh Farrar, Jeremy J Khor, Chiea Chuen
Enteric fever affects more than 25 million people annually and results from systemic infection with Salmonella enterica serovar Typhi or Paratyphi pathovars A, B or C(1). We conducted a genome-wide association study of 432 individuals with blood culture-confirmed enteric fever and 2,011 controls from Vietnam. We observed strong association at rs7765379 (odds ratio (OR) for the minor allele = 0.18, P = 4.5 × 10(-10)), a marker mapping to the HLA class II region, in proximity to HLA-DQB1 and HLA-DRB1. We replicated this association in 595 enteric fever cases and 386 controls from Nepal and also in a second independent collection of 151 cases and 668 controls from Vietnam. Imputation-based fine-mapping across the extended MHC region showed that the classical HLA-DRB1*04:05 allele (OR = 0.14, P = 2.60 × 10(-11)) could entirely explain the association at rs7765379, thus implicating HLA-DRB1 as a major contributor to resistance against enteric fever, presumably through antigen presentation.