Association betweenCryptosporidiumInfection and Human Leukocyte Antigen Class I and Class II Alleles

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Abstract
Background.Cryptosporidium species are a common cause of diarrhea, which can be severe and protracted in young children and immunocompromised individuals. Methods. A cohort of 226 Bangladeshi children aged 2–5 years was prospectively followed for >3 years to study the role of host genetics in susceptibility to infection, as well as the community impact of cryptosporidiosis on this population. Results. Ninety-six children (42.5%) received a diagnosis of Cryptosporidium infection. A total of 51 (22.6%) had asymptomatic infection. Fifty-eight (25.7%) had cryptosporidiosis, of whom 17 (29.3%) had recurrent disease. Children with cryptosporidiosis presented early, and most had abdominal pain and a short course of diarrhea. Infected children were more likely to carry the human leukocyte antigen (HLA) class II DQB1*0301 allele, particularly those with asymptomatic and symptomatic infection (P = .009); a strong association was found between carriage of the DQB1*0301/DRB1*1101 haplotype and development of both asymptomatic and symptomatic infection (P = .008). Infected children were also more likely to carry the B*15 HLA class I allele. Conclusions. This is the first study to describe a possible genetic component of the immune response to Cryptosporidium infection, which includes HLA class I and II alleles. Cryptosporidiosis in Bangladeshi children aged 2–5 years is common and often recurrent, but the duration is shorter and the abdominal pain greater than that described in children aged <2 years.