Prevalence and Comparison of HLA-B27 among Ankylosing Spondylitis Patients in Palestine and Arab Population

Rozan Attili/ Abedalkhader, Ayman Hussein, Hilal Odeh and Hatem Hijaz

Background: HLA-B27 antigen is genetic markers which have a strong risk association with ankylosing spondylitis (AS). Data about HLA-B27 prevalence among Palestinian populations are very limited and controversial when compared to Western population’s esp. in Mediterranean countries.

Objective: To investigate the incidence and prevalence of HLA-B27 among Palestinian populations and its association with ankylosing spondylitis (AS). To compare data from Palestinian populations with other larger studies done among Arab and African populations.

Methods: HLA-B27 was studied among a total number of one hundred twelve patients with symptoms of AS referred for further HLA-B27 genetic testing with AS symptoms were referred for genetic testing during the time period between January 2013 and January 2014 and 39 controls. DNA was extracted from a 200 μl peripheral blood then genotyped for polymorphisms by real time polymerase chain reaction chain reaction system. Published studies of HLA-B27 were reviewed in Arab patients. We divided Arab populations into three parts: A) Levant which includes Jordan, Syria, Lebanon, and Palestine, B) Arabian Peninsula which includes Saudi Arabia, UAE, Kuwait, Qatar, C) North Africa which includes Egypt, and Morocco. We looked up all the articles from PubMed and Medline addressing HLA-B27 prevalence among all these areas on AS patients and healthy individuals. We also searched for large studies conducted on western populations over the last couple of years for comparison.

Results: We observed that the general prevalence of HLA-B27 among Palestinian was 20.5% in which 10 (43.4%) male 8 (34.7%). The prevalence of HLA-B27 among patients with AS is 71% in Jordan, 60% Syria, 23.6% Lebanon, 58.7% Egypt, 29.3% Morocco, 67% Saudi Arabia, 25.7% Kuwait, 74% in Qatar and 56% UAE.

Conclusion: To conclude our study, HLA-B27 is presented in about 20% percent of the Palestinian population. Further comprehensive-cooperative research would be helpful if including the 3 health sectors would be very helpful in establishing a more accurate and comprehensive estimate of the size of the problem in Palestine and to further provide an accurate profile of AS in Palestine.