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Tuberculosis is caused by
Mycobacterium tuberculosis
complex (MTBC), however, the distribution and frequency of MTBC lineages and sublineages vary in different parts of the globe.
Mycobacterium africanum
, a member of MTBC is responsible for a large percentage of TB cases in West Africa, however, it is rarely identified outside of this part of the World. Whether or not differential HLA polymorphism (an important host factor) is contributing to the geographic restriction of
M. africanum
to West Africa is unknown. Here, we conducted a cohort study in Mali of newly diagnosed individuals with active pulmonary TB and normal healthy controls. The MTBC isolates were spoligotyped to determine the TB study groups (
M. tuberculosis
sensu stricto LAM10 and
M. africanum
), and HLA typing was performed on peripheral blood. Unlike previous reports on other populations, we found that HLA Class-I alleles were significantly associated with active TB disease in this population. HLA-B alleles (B*07:02, B*08:01, B*14:02, B*15:03, B*15:10, B*18:01, B*42:01, B*42:02, B*51:01 and B*81:01) were significantly associated with
M. africanum
(40–45%) and
M. tuberculosis
(75%) compared to healthy controls. Many HLA-A alleles (A*02:05, A*34:02, A*66:01 and A*68:02) were also associated with both TB groups (65–70%). However, many Class II HLA-DR variants were found to be associated with
M. tuberculosis
but not
M. africanum
with the exception of the DRB1*03:01, which was associated with both groups. The differential HLA distribution observed in this study might be at least partially responsible for the geographical restriction of
M. africanum
infections to West Africa.