Correlations between incidence of syphilis and frequencies of human leukocyte antigens haplotypes in China: An ecological study

In China, the incidence of syphilis varies across different regions, as do the frequencies of HLA haplotypes. The progression and stages of syphilis infection may be associated with HLA polymorphisms. This study employed an ecological study design, utilizing data from a nationwide survey on the distribution of HLA frequencies in the Chinese Bone Marrow Donor Program and the incidence of syphilis in China during the same period. Pearson and Spearman correlation analyses, adjusted for multiple testing using the Benjamini-Hochberg procedure, were performed to investigate the correlation between HLA polymorphism and the incidence of syphilis. The overall incidence of syphilis was significantly correlated with the frequencies of six specific HLA-A-C-B-DRB1-DQB1 haplotypes in China. Additionally, as many as 24 HLA-A-C-B-DRB1-DQB1 haplotypes were found to be correlated with the incidence of congenital syphilis. Nominal correlations were observed between several HLA haplotype frequencies and the incidences of secondary, tertiary, and latent syphilis prior to false discovery rate correction. These findings suggest that the frequencies of HLA haplotypes are correlated with the incidence of syphilis in China, particularly in congenital syphilis cases. Collectively, susceptibility to syphilis infection and disease progression appears to be closely linked to HLA polymorphisms.