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Human Leukocyte Antigen B27 (HLA-B27)

What Is an HLA-B27 Test?


  1. The human leukocyte antigen B27 blood test is also known as the HLA-B27 test.
  2. The HLA-B27 test is used to identify a specific protein on your white blood cells that can be a sign of autoimmune disease.
  3. This test is one step in the process of diagnosing a potential autoimmune disorder.

Human leukocyte antigen B27 (HLA-B27) is a protein located on the surface of your white blood cells. An HLA-B27 test is a blood test that identifies HLA-B27 proteins.

Human leukocyte antigens (HLAs) are proteins commonly found on white blood cells. These antigens help your immune system identify the differences between healthy body tissue and foreign substances that may cause infection.

Although most HLAs protect the body from harm, HLA-B27 is a specific type of protein that contributes to immune system dysfunction. The presence of HLA-B27 on your white blood cells can cause your immune system to attack those otherwise healthy cells. When this occurs, it can result in an autoimmune disease, such as juvenile rheumatoid arthritis.

Why Is the Test Ordered?


Monitoring Disease Progression

The presence of HLA-B27 is associated with certain autoimmune diseases, including:

  • ankylosing spondylitis, which causes inflammation of the bones in the spine
  • reactive arthritis, which causes inflammation of the joints, urethra, and eyes, and sometimes lesions on the skin
  • juvenile rheumatoid arthritis
  • anterior uveitis, which causes swelling and irritation in the middle layer of the eye

A doctor may order the HLA-B27 test to monitor the progression of these and other autoimmune diseases.

Diagnostic Uses

For people with specific symptoms, the HLA-B27 test may be used along with other blood, urine, or imaging tests to confirm the diagnosis of an autoimmune disease. The symptoms that might prompt a doctor to order the test include:

  • joint pain
  • stiffness or swelling of the spine, neck, or chest
  • inflammation of the joints or urethra accompanied by skin lesions
  • recurring inflammation in the eye

Your doctor can order HLA antigen tests, including tests for HLA-B27, when you’re undergoing a kidney or bone marrow transplant. These tests can be used to match a donor’s tissue to the person receiving the kidney or bone marrow.

How Is the Test Administered?


The HLA-B27 test involves a standard blood draw. A healthcare provider in a doctor’s office or a clinical lab administers it. The blood sample is usually taken from the arm using a small needle. The blood will be collected in a tube and sent to a lab for analysis.

Most of the time, no special preparation is necessary. However, talk to your doctor to see if you need to stop taking any of your medications before the blood draw.

What Are the Risks of the Test?

Risk Factors

Some people may experience some discomfort when their blood is drawn. You may feel pain at the puncture site during the test and mild pain or throbbing at the puncture site after the test.

Undergoing the HLA-B27 test carries minimal risks. All blood tests have the following risks:

  • difficulty obtaining a sample, which results in multiple needle sticks
  • excessive bleeding at the puncture site
  • fainting
  • lightheadedness
  • an accumulation of blood under the skin called a hematoma
  • an infection at the puncture site

Interpreting Your Results


A negative test indicates the absence of HLA-B27 in your blood. However, if the test is negative, it doesn’t mean that you don’t have an autoimmune disorder. When making a final diagnosis, your doctor will consider all test results along with your symptoms. Sometimes, people with autoimmune disorders don’t have HLA-B27 on their white blood cells.

If the test is positive, this means that HLA-B27 is present in your blood. Although a positive result may be cause for concern, the presence of the antigen doesn’t always mean that an autoimmune disorder will develop. Diagnosis of an autoimmune disorder must be made based on your symptoms and the results of all blood tests and diagnostic exams.

The Takeaway


The HLA-B27 blood test is one step in the process of diagnosing a potential autoimmune disorder. Neither positive nor negative results to the test should be taken as confirmation of whether you have an autoimmune disorder or not. Your doctor will talk to you about the next steps after you receive the results.

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