Tumour necrosis factor-alpha promoter region polymorphisms and spontaneous HBsAg clearance.

摘要

I read with a great interest the recent article by Kao et al. . The article has important outcomes related to mechanisms underlying hepatitis B virus (HBV) clearance. But, there are some issues to be also discussed. The first item of my concern is the missing data of age and mode of viral transmission that are very important determinants in HBV clearance. Age at infection is probably the most important factor on clinical outcome. Secondly, the authors ignored the major histocompatibility complex (MHC) genotype effect on the results in their discussion. This is important because the tumour necrosis factor-alpha gene is located within the class III region of MHC between HLA-B and -DR. Moreover, an inappropriate viral presentation to T lymphocytes controlled by MHC genes may affect the viral clearance