Human leukocyte antigen variants and clinical features of primary biliary cholangitis: Cumulative contributions

This letter to the editor highlights the importance of considering potential cumulative contributions among human leukocyte antigen (HLA) alleles in shaping the clinical manifestations of primary biliary cholangitis. Complementing the overview by Curto <i>et al</i>, which focused on non-HLA candidate genes, this paper emphasizes that specific haplotypes of <i>HLA-DRB1</i>, <i>HLA-DQA1</i>, and <i>HLA-DQB1</i>, as well as HLA-G*01:01:01:08/UTR-1, may modulate disease heterogeneity, predisposition to primary biliary cholangitis and autoimmune hepatitis overlap syndrome, disease progression, and poorer therapeutic response. A comprehensive understanding of these HLA polymorphisms and their interactive effects is essential for improving risk stratification and guiding personalized management of this complex autoimmune liver disease.