Clinical outcomes following exposure to hepatitis B virus vary enormously from spontaneous clearance to chronic hepatitis B, often progressing to liver cirrhosis and hepatocellular carcinoma. The presence and expression of polymorphisms in the HLA-DQB1 gene have been shown to correlate with spontaneous clearance and susceptibility to HBV infection. This study aimed to determine the association of HLA-DQB1 gene polymorphisms with chronic hepatitis B infection, cirrhosis, and HBV-related HCC in Burkina Faso. This case-control study was conducted in Ouagadougou, Burkina Faso, from August 2022 to May 2023. It characterized the HLA-DQB1 gene polymorphism (HLA-DQB1*0303, HLA-DQB1*0502, HLA-DQB1*0604) in 111 participants stratified into four groups: HCC (n=35), cirrhosis (n=13), chronic hepatitis B (CHB, n=37), and healthy controls (n=26). HLA-DQB1*03: 03, *05: 02, and *06: 04 alleles were characterized using PCR with sequence-specific primers (PCR-SSP). Data were analyzed using SPSS version 21 and R version 4.3.1. Our data suggest that HLA-DQB1*0502 (OR=28.4; 95%CI= 5.7-141.3; p-value <0.01; OR=7.1; 95%CI = 1.43-35.02 and p-value <0.01) was a risk factor for progression from hepatitis B to CHB and HCC. However, this allele also appeared to have a protective effect against cirrhosis (OR=0.03; 95%CI=0.004-0.305; p-value=<0.01). Carriers of the HLA-DQB1*0303 allele iniquitously had a higher risk of developing cirrhosis following chronic HBV infection (OR=29.4; CI95%=3.4-254.67, p-value<0.01). The simultaneous absence of HLA-DQB1*0502/HLA-DQB1*0604 alleles showed statistically significant values in healthy controls versus patients with HCC (58.5% versus 41.5%) (OR=0.03; CI95%=0.02-0.38; p-value<0.01). Our results revealed that carrying the HLA-DQB1*0502 allele could induce susceptibility to the progression of infection to critical stages, and the HLA-DQB1*0303 allele could be protective against the progression of hepatitis B.

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