Immune Phenotype of Chronic Liver Disease
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Immune disorders in chronic liver disease mayreflect common host propensities or diseasespecificfactors. Our aim was to determine the principal basesfor these expressions. Four hundred fifty-one patients with various chronic liver diseases wereassessed prospectively for concurrent immune disorders.Individuals with immune diseases were more frequentlywomen (73% vs 60%, P = 0.02) and they had HLA DR4 more often than counterparts with other HLA(46% vs 23%, P = 0.000008). The association between HLADR4 and immune disease was apparent within individualliver diseases and within different categories of liver disease. Women with HLA DR4 had ahigher frequency of immune disease than women withoutHLA DR4 (52% vs 22%, P ≤ 0.000001), and they also hadimmune diseases more commonly than DR4-positive men (52% vs 31%, P = 0.03). DR4-positive men,however, had higher frequencies of immune disease thanDR4-negative men, especially in the nonimmune types ofliver disease (26% vs 4%, P = 0.002). We conclude that HLA DR4 and female gender constitute animmune phenotype that is an important basis forautoimmune expression in chronic liverdisease.
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