To editor:

I read the interesting paper entitled Spondyloarthritis in North Africa: an update which has been published by Silmani et al. in clinical rheumatology [1]. I decided to critique a small part of it briefly, which is about the clinical relevance of HLA-B*27 polymorphisms in patients with ankylosing spondylitis (AS) in Asia. They included in their paper: “This is contrary to the findings reported for Asian populations, for whom HLA-B*27 polymorphisms may affect disease phenotype, particularly B*2704 and B*27015, which are associated with earlier disease onset and more frequent uveitis than B*2705 among Asian patients” [1]. One of the articles cited by Salmani and her colleagues on this subject is the article by Fallahi et al. [2]. It should be noted that in Fallahi et al.’s study, none of the patients with AS was HLA-B*27015 positive at all and the HLA-B27-positive polymorphisms were as follows: 48.4% B*2705, 42.6% B*2702, 5.7% B*2704, and 3.3% B*2707. As can be seen, HLA-B*2704 and HLA-B*2707 subtypes account for a small percentage. Also, earlier disease onset and uveitis were not more frequent significantly than the more common subtypes (including HLA-B*2705 and HLA-B*2702) in this study. However, clinical trends toward less dorsal kyphosis and less decrease in cervical slope (without statistically significance) were observed in patients with B*2704 and B*2707 [2]. In conclusion, uveitis and earlier onset of AS may be more frequent for HLA-B*2704 or HLA-B*27015 among China and Far East population according to some researchers [3, 4]. However, this cannot be extended to all parts of Asia, especially Iran or Middle East Asia.