BACKGROUND
Patients with hepatitis C virus (HCV) and hepatocellular carcinoma (HCC) may or not develop iron overload (IO), which is associated with worst prognosis, because can cause serious damage to organs.
HFE
gene controls the iron uptake from gut, particularly in patients with hereditary hemochromatosis (HH).
AIM
To identify associations between
HFE
coding region in patients exhibiting hereditary hemochromatosis and in diseases associated with acquired IO.
METHODS
We sequenced exons 2 to 5 and boundary introns of
HFE
gene, evaluating all polymorphic sites in patients presenting hereditary (hemochromatosis) or acquired iron overload HCV and HCC) and in healthy controls, using Sanger sequencing. We also determined the ensemble of extended haplotype in healthy control individuals, including several major histocompatibility complex loci, using sequence specific probes. Haplotype reconstruction was performed using the Arlequin and Phase softwares, and linkage disequilibrium (LD) between histocompatibility loci and
HFE
gene was performed using the Haploview software.
RESULTS
The
HFE
*003 allele was overrepresented (
f
= 71%) and
HFE
*001 allele was underrepresented (
f
= 14%) in HH patients compared to all groups. A strong linkage disequilibrium was observed among the
H63D-G
,
IVS2(+4)-C
and
C282Y-G
gene variants, particularly in HH; however, the mutation
IVS2(+4)T>C
was not directly associated with HH susceptibility. The
HFE
*001/
HFE
*002 genotype conferred susceptibility to HCC in HCV patients exhibiting IO (
P
= 0.02, OR = 14.14). Although
HFE
is telomeric to other histocompatibility genes, the
H63D-G/IVS2(+4)-C
(
P
≤ 0.00001/
P
≤ 0.0057) combination was in LD with
HLA-B
*44 allele group in healthy controls. No LD was observed between
HFE
alleles and other major histocompatibility loci.
CONCLUSION
A differential
HFE
association was observed for HH and for diseases associated with acquired IO (HCV, HCC). Since
HFE
is very distant from other histocompatibility loci, only weak associations were observed with these alleles.