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To confirm and refine associations of human leukocyte antigen (HLA) genotypes with variable antibody (Ab) responses to hepatitis B vaccination, we have analyzed 255 HIV-1 seropositive (HIV(+)) youth and 80 HIV-1 seronegatives (HIV(-)) enrolled into prospective studies. In univariate analyses that focused on HLA-DRB1, -DQA1, and -DQB1 alleles and haplotypes, the DRB1*03 allele group and DRB1*0701 were negatively associated with the responder phenotype (serum Ab concentration > or = 10 mIU/mL) (P = 0.026 and 0.043, respectively). Collectively, DRB1*03 and DRB1*0701 were found in 42 (53.8%) out of 78 non-responders (serum Ab <10 mIU/mL), 65 (40.6%) out of 160 medium responders (serum Ab 10-1,000 mIU/mL), and 27 (27.8%) out of 97 high responders (serum Ab >1,000 mIU/mL) (P < 0.001 for trend). Meanwhile, DRB1*08 was positively associated with the responder phenotype (P = 0.010), mostly due to DRB1*0804 (P = 0.008). These immunogenetic relationships were all independent of non-genetic factors, including HIV-1 infection status and immunodeficiency. Alternative analyses confined to HIV(+) youth or Hispanic youth led to similar findings. In contrast, analyses of more than 80 non-coding, single nucleotide polymorphisms within and beyond the three HLA class II genes revealed no clear associations. Overall, several HLA-DRB1 alleles were major predictors of differential Ab responses to hepatitis B vaccination in youth, suggesting that T-helper cell-dependent pathways mediated through HLA class II antigen presentation are critical to effective immune response to recombinant vaccines.

The South Africa Stress and Health Study (SASH) is a large psychiatric epidemiological survey that is currently underway in South Africa. It is a part of the World Health Organization's World Mental Health (WMH) 2000 initiative and seeks to complete interviews with a nationally representative sample of 5000 adults. The WMH initiative is obtaining population-based data on the prevalence and severity of specific psychiatric disorders, demographic and psychosocial correlates of these diagnoses, and the levels and adequacy of mental health service utilization. SASH is using the fully structured pencil and paper version of the WHO Composite International Diagnostic Interview (CIDI) to assess lifetime and 12-month rates of mental disorders using both the DSM-IV and the ICD-10 diagnostic systems. In addition, the SASH seeks to collect information on the prevalence of exposure to physical and psychological torture in South Africa and to assess the association between such traumas and specific psychiatric disorders. It will also assess a broad range of risk factors and resources that may modify the association between exposure to human rights violations and mental health.