Background & AimsPrimary biliary cirrhosis (PBC) is an autoimmune liver disease. Genetic factors are critical in determining susceptibility to PBC. Among human leuocyte antigen (HLA) genes, an association between the DRB1*08 allele and PBC has been reported in many populations, but not in Chinese patients. MethodsWe investigated HLA-A, B, DRB1, and DQB1 alleles and haplotypes in 145 PBC patients and 500 healthy subjects. Patients were also stratified according to autoantibody features, and associations between these and HLA alleles were analyzed. ResultsSignificant associations existed between HLA-DRB1*08:03 (22.1% vs. 9.0%, Pc<0.0001, OR=2.86), DQ2 (41.4% vs. 25.4%, Pc<0.0001, OR=2.07) and DQB1*06:01 (31.0% vs. 17.8%, Pc=0.014, OR=2.08) alleles and PBC. DRB1*08:03-DQB1*06:01 (22.1% vs. 8.2%, P<0.0001, OR=3.17) and DRB1*07:01-DQB1*02:02 haplotypes (28.3% vs. 17.6%, P=0.005, OR=1.85) were also associated with PBC susceptibility. In contrast, the DQB1*03:01 allele (21.4% vs. 39.2%, Pc<0.0001, OR=0.42) and DRB1*12:02-DQB1*03:01 haplotype (6.9% vs. 14.6%, P=0.015, OR=0.43) were significantly decreased in PBC patients compared with controls. DRB1*14:54 and DQ5(1) protected against antinuclear antibody (ANA) (OR=0.25) and anti-gp210 antibody (OR=0.39) production, respectively, while HLA-B*44:03 predisposed patients to anti-gp210 antibody (OR=5.70) production. ConclusionThese results suggest that Chinese patients with PBC have a distinct genetic background in eastern Asia, and we confirmed the role of HLA genes in determining PBC susceptibility and autoantibody features in the Chinese population.