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HLA-DRB1*04 Allele Is Associated with Severe Malaria in Northern Ghana

Several associations between specific HLA alleles and susceptibility or resistance to Plasmodium falciparum malaria have been previously reported, but no associations have been confirmed in multiple populations. We studied associations between HLA-A, -B, and DRB1 alleles and severe malaria in northern Ghana. We analyzed HLA-DRB1*04 in 4,032 subjects from a severe malaria case-control study, 790 severe malaria cases, 1,611 mild malaria controls, and 1631 asymptomatic controls. The presence of HLA-DRB1*04 was associated with severe malaria (OR = 2.42, 95% CI = 1.64, 3.58). The allele frequency of DRB1*04 was similar in the two major ethnic groups in the study population, Kassem (4.4%) and Nankam (4.7%), and the OR for the association between DRB1*04 and severe malaria was similar in both ethnic groups. These findings are consistent with results from Gabon suggesting that DRB1*04 is a risk factor for severe malaria.

Received May 10, 2007. Accepted for publication July 17, 2007.

Financial support: This study was supported by US Naval Medical Research Center work unit number 6000.RAD1.F.A0309 and National Institutes of Allergy and Infectious Diseases, National Institutes of Health contract NO1 AI95363; publications supported by this contract are subject to prior review and approval by DMID/NIAID/NIH.

Disclaimer: The opinions expressed herein are those of the authors only and do not purport to express the official views of the US Navy or the Department of Defense. The authors have no commercial or other association that might pose a conflict of interest.

^* Address correspondence to William O. Rogers, American Embassy Jakarta, NAMRU-2 FPO AP 96520-8132. E-mail: mrogers70{at}yahoo.com

Authors’ addresses: Awo D. Osafo-Addo, Harvard School of Public Health, Department of Immunology and Infectious Diseases, 677 Huntington Avenue, Boston, MA 02115, Telephone: 617-432-1563. Kwadwo A. Koram, Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana at Legon, Accra, Ghana, Telephone: 233-21-513207, Fax: 233-21-502182. Abraham R. Oduro, Navrongo Health Research Center, Ministry of Health, PO Box 114, Navrongo, UER Ghana, Telephone: 233-742-22380, Fax: 233-742-22310. Michael Wilson, Noguchi Memorial Institute for Medical Research, University of Ghana at Legon, Accra, Ghana, Telephone: 233-21-513207, Fax: 233-21-502182. Abraham Hodgson, Navrongo Health Research Center, Ministry of Health, PO Box 114, Navrongo, UER Ghana, Telephone: 233-742-22380, Fax: 233-742-22310. William O. Rogers, American Embassy Jakarta, NAMRU-2, Unit 8132, FPO AP 96520-8132, Telephone: 62-21-421-4457, Fax: 62-21-242-4507, E-mail: rogerswo{at}namrutwo.org.