Immunogenetic study of programmed death-ligand 1 variation and hepatitis B virus in Iraqi patients with chronic myeloid leukemia
Abstract
Background & objective: Patients with chronic myeloid leukemia (CML) remain at a risk of hepatitis B virus (HBV) reactivation during tyrosine kinase inhibitor (TKI) therapy. Programmed death-ligand 1 (PD-L1) polymorphisms may influence immune evasion and disease pathogenesis; however, their interaction with HBV in CML, particularly in Iraqi populations, remains uncharted. We conducted this study to investigate PD-L1 genetic variations, serum PD-L1 levels, and HBV virus infection.
Methodology: This was a case-control study of 120 patients with CML and 100 healthy controls (AHC). Serum PD-L1 and HBV markers were quantified by ELISA Genomic DNA was extracted, and specific regions of the PD-L1 gene and HBV DNA were amplified by PCR. PD-L1 amplicons were sequenced to identify genetic variants.
Results: CML patients exhibited significantly lower serum PD-L1 levels than controls (mean 268.8 ± 89 vs. 470.6 ± 288, P = 0.0032). No HBV DNA was detected in any participant. A novel C>T substitution in PD-L1 was identified, with TT and CT genotypes being more frequent in CML patients than in controls. The T allele showed a borderline significant association with a reduced CML risk (P = 0.01, OR = 0.22, 95% CI: 0.06–0.73).
Conclusion: The PD-L1 T allele may confer protection against CML, while suppression of serum PD-L1 suggests distinct regulatory mechanisms. The absence of HBV highlights regional epidemiological patterns. PD-L1 genotyping can inform risk stratification of patients with Iraqi CML.
Abbreviations: CML: chronic myeloid leukemia, HBV: hepatitis B virus, PD-L1: TKI: tyrosine kinase inhibitor
Keywords: Chronic myeloid leukemia, Programmed Death-Ligand 1, Hepatitis B virus, Immune checkpoint.
Citation: Hassan DO, Jawad AH, Al-Alwany SHM. Immunogenetic study of programmed death-ligand 1 variation and hepatitis B virus in Iraqi patients with chronic myeloid leukemia. Anaesth. pain intensive care 2025;29(7):749-755. DOI: 10.35975/apic.v29i7.2967
Received: May 09, 2025; Revised: October 26, 2025; Accepted: January 01, 2025
