To the Editor.—
We read with interest the article by Weissman et al that reports an association of HLA-DR3, DR4, and DR7 with nonresponsiveness to recombinant hepatitis B vaccine.1 These same HLA-DR antigens have an increased prevalence of celiac disease, a disorder in which an immune response to dietary gliadin seems to underlie the intestinal damage. HLA-DR3 and DR7 have in common a frequent association with the allele DQ2. It now seems that the "primary" association with celiac disease may be that of HLA-DQ2.2-5 It would be interesting to see if the nonresponders with HLA-DR3 and DR7 in the study by Weissman et al also have HLA-DQ2.In the case of celiac disease, a collaborative study by the Ninth Histocompatibility Workshop found that in a group of patients with celiac disease who lacked either DR3 or DR7, some had DQ2 in the absence of DR3 or DR7, while
McCombs CC, Michalski JP. HLA and Immune Response. JAMA. 1989;262(6):774. doi:10.1001/jama.1989.03430060068021
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