Association of Fatal Aneurysmal Subarachnoid Hemorrhage with Human Leukocyte Antigens in the Finnish Population

Abstract

Human leukocyte antigens (HLA) have been reported to associate with the risk of aneurysmal subarachnoid hemorrhage (SAH) and poor outcome after SAH. Our aim was to identify HLA antigens that associate with the risk of fatal SAH in the Finnish population. Medical records of 600 cadaveric organ donors were reviewed to find organ donors that succumbed to SAH ( n = 232) or brain trauma ( n = 151). HLA antigen frequencies in these groups were compared with HLA frequenciens in a reference population of 10,000 bone marrow donors. Chi-Square test with Bonferroni correction and multiplicative logistic regression models were used and false positive result probabilities (FPRP) were calculated. Alpha-level was 0.01. HLA-A3 associated with fatal SAH ( p = 0.0014, OR 1.3 and 95%CI 1.1–1.6) and HLA-DR7 inversely associated with fatal SAH ( p = 0.0040, OR 0.3 and 95%CI 0.2–0.6). HLA-A3 but not HLA-DR7 showed also a positive trend in donors with brain trauma. FPRP was below 0.5 for HLA-A3, but clearly above 0.5 for HLA-DR7. HLA-A3 seems to associate with fatal SAH in the Finnish population. Further studies are needed to reveal the pathobiologic mechanisms for how HLA-A3 associates with the risk of fatal SAH in Finns.