Associations among human leukocyte antigen (HLA) class II DQ variants, bacterial sexually transmitted diseases, endometritis, and fertility among women with clinical pelvic inflammatory disease

Background: We investigated associations between HLA class II DQ alleles, chlamydial and gonococcal cervicitis, endometritis, and infertility among women with pelvic inflammatory disease (PID). Methods: Ninety-two women with clinical signs and symptoms of mild-to-moderate PID, enrolled in the PEACH Study, were evaluated. For all HLA class II DQ allelles with a prevalence of 10% or greater in the population, we assessed demographics, cervical infections, endometrial pathology, and fertility outcomes. Results: Chlamydial cervicitis, gonococcal cervicitis, endometritis, and infertility were all more common among women carrying the DQA *0301 allele after adjustment for race. Endometritis and infertility were somewhat less common (or pregnancy more common) among women carrying the DQA *0501 and DQB *0402 allelles. Conclusion: Among women with signs and symptoms of PID, carriage of the DQA *0301, DQA *0501, and DQB *0402 alleles altered the occurrence of lower genital tract infection, upper genital tract inflammation, and infertility.