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Background  Evidence suggests that human leukocyte antigen (HLA) alleles influence the host immune response against  Mycobacterium leprae . However, the association between HLA alleles and borderline (B) leprosy has not been studied. The aim of this study was to determine whether HLA class I and II molecules are associated with susceptibility or resistance to B leprosy including borderline-tuberculoid (BT), borderline-borderline (BB), and borderline-lepromatous (BL).    Methods  DNA was obtained by the  salting-out  technique from the blood samples of 202 patients with B leprosy and 478 control subjects. HLA class I (A*, B*, and C* loci) and class II (DRB1* and DQB1* loci) genotypes were determined by polymerase chain reaction amplification and reverse hybridization with sequence-specific oligonucleotide probes and sequence-specific primers.    Results  The case-controlled analysis results showed a significant association between B leprosy and HLA-C*05 (5.94%  vs . 14.02%;  p =  0.002, OR = 0.38, 95% CI = 0.20–0.73,  pc =  0.032) and HLA-DRB1*07 (16.34%  vs . 26.77%;  p =  0.003, OR = 0.53, 95% CI = 0.3–0.8,  pc =  0.039). A protective association was observed between BL leprosy and HLA-DQB1*02 (18.18%  vs . 39.53%;  p  = 0.005, OR = 0.34, 95% CI = 0.15–0.75,  pc  = 0.025). In reactional patients, a significant association was observed between HLA-B*15 (28.72%  vs.  12.76%;  p  = 0.011, OR = 2.75, 95% CI = 1.30–5.85,  pc  = 0.352) and predisposition to reversal reaction. Haplotype analysis showed that A*02-B*07-C*07-DRB1*15-DQB1*06 (2.97%  vs.  1.04%;  p  = 0.015) and A*02-B*40-C*03-DRB1*13-DQB1*06 (1.73%  vs.  0.10%;  p  = 0.0011) were associated with susceptibility to the B form. The presence of the HLA-DRB1*02 or HLA-DRB1*03/HLA-DQB1*01 haplotypes in B patients (22.05%  vs.  33.0%;  p =  0.005) suggested the involvement of these haplotypes in this clinical form of the disease.    Conclusions  The results indicate the involvement of HLA class I and class II molecules in B leprosy and reversal reactions; it also suggest a role for HLA in polarization of the disease in this group of patients.    Electronic supplementary material  The online version of this article (doi:10.1186/s12879-015-0751-0) contains supplementary material, which is available to authorized users.

bmc infectious diseases

Human leukocyte antigen class I and class II alleles are associated with susceptibility and resistance in borderline leprosy patients from Southeast Brazil