Can HLA-B27 positive turn negative?

May 16, 2023 Source: Cainiu Health

Dr. Liu Aihua

Introduction

The HLA-B27 positive status is usually lifelong and does not change to negative. However, not every individual carrying HLA-B27 will develop an autoimmune disease. Therefore, being HLA-B27 positive does not necessarily lead to autoimmune disease; a comprehensive clinical evaluation and treatment should be based on the patient's medical history, symptoms, and physical signs.

HLA-B27 positivity is irreversible; once an individual tests positive for HLA-B27, it is highly unlikely to become negative. The detailed explanation is as follows:

HLA-B27 is a type of human leukocyte antigen located on the short arm of the human genome and is associated with various autoimmune diseases, including ankylosing spondylitis, psoriatic arthritis, and enteropathic arthritis. HLA-B27 positivity itself is not a disease but merely indicates that the individual carries the gene for this antigen. Once someone tests positive for HLA-B27, the status is typically lifelong, and currently there is no known method to convert it to negative. However, although HLA-B27 positivity is linked to an increased risk of certain autoimmune diseases, it does not mean that every person carrying HLA-B27 will develop an autoimmune disorder. Many individuals with HLA-B27 never experience symptoms of autoimmune diseases, and even when symptoms do occur, they may not necessarily be related to HLA-B27 positivity. Therefore, if a person is HLA-B27 positive, clinical evaluation should be based on their specific medical history, symptoms, and physical findings, and preventive and therapeutic measures should be carried out under the guidance of a physician.

In summary, HLA-B27 positivity is usually lifelong and cannot turn negative. However, carrying the HLA-B27 antigen does not inevitably lead to autoimmune diseases. A comprehensive clinical assessment and treatment plan must take into account the patient’s medical history, symptoms, and clinical signs.

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What does HLA-B27 gene testing mean?

HLA-B27 gene testing is a genetic test used to determine whether an individual carries the HLA-B27 gene, which is associated with autoimmune diseases such as rheumatoid arthritis and ankylosing spondylitis. A positive test result does not necessarily mean that a person has these diseases, but it may indicate an increased risk. It is important to have thorough communication and discussion with a doctor before undergoing the test.

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Which is more severe: ankylosing spondylitis with positive or negative HLA-B27?

Ankylosing refers to ankylosing spondylitis. Generally, HLA-B27 positive ankylosing spondylitis is more severe than HLA-B27 negative cases. Patients are advised to follow medical instructions for symptomatic treatment. Ankylosing spondylitis is a disease primarily characterized by inflammatory lesions in the sacroiliac joints and spinal attachment sites. It belongs to the category of autoimmune diseases within rheumatology; therefore, the condition in HLA-B27 negative patients tends to be slightly milder than in those who are HLA-B27 positive.