Human platelet antigen polymorphisms (HPA-1, -2, -3, -4, -5 and -15) in major ethnic groups of Pakistan

F A Bhatti, M Uddin, A Ahmed, P Bugert
Transfusion Medicine 2010, 20 (2): 78-87

OBJECTIVES: Gene frequencies of human platelet antigens (HPA) determine the magnitude of platelet immunological disorders like neonatal alloimmune thrombocytopenia, platelet refractoriness and ease of availability of particular HPA-typed platelet donors in a given community.

BACKGROUND: However, the pattern of HPA in Pakistani population is not known.

AIM: The aim of present study was to determine the gene frequencies of HPA (HPA-1 to -5 and -15) in individuals belonging to major ethnic groups and castes of Pakistani population.

MATERIALS AND METHODS: HPA genotyping was done in 593 individuals belonging to all ethnic groups of Pakistan, by polymerase chain reaction-sequence specific primers with detection on polyacrylamide electrophoresis.

RESULTS: The gene frequencies of the 'a' and 'b' alleles of HPA-1 to -5 and -15 in Pakistanis were as follows: HPA-1a/b, 0.885/0.115; HPA-2a/b, 0.92/0.08; HPA-3a/b, 0.69/0.31; HPA-4a/b, 1/0; HPA-5a/b, 0.9/0.1; HPA-15a/b, 0.59/0.41. Except for significant difference regarding gene frequency of HPA-3 between Pathans and Sindhis, there was no significant difference of HPA-1 to -5 and -15 between major ethnic groups of Pakistan. The estimated mismatch probability regarding platelet antigens 1-5 and 15 in Pakistanis, after transfusion of random donor platelets, is from 14 to 37%. The expected incidence of neonatal alloimmune thrombocytopenia due to anti-HPA-1a in Pakistani pregnant females is < 1 of 1000 pregnancies and 8-12 of 1000 in case of anti-HPA-5b. Homozygosity of HPA-1b, -2b and -5b genotypes ranged from 1 to 2% in the Pakistani population, whereas homozygosity of HPA-3b and -15b was 11 and 18%.

CONCLUSIONS: There is a need to establish donor registries typed for HPA in the transfusion centres of the country.

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