HLA-B27 is a blood test to look for a protein that is found on the surface of white blood cells. The protein is called human leukocyte antigen B27 (HLA-B27).
Human leukocyte antigens (HLAs) are proteins that help the body's immune system tell the difference between its own cells and foreign, harmful substances.
Human leukocyte antigen B27
How the Test is Performed
A blood sample is needed. Most of the time, blood is drawn from a vein located on the inside of the elbow or the back of the hand.
How to Prepare for the Test
In most cases, no special steps are needed to prepare for the test.
How the Test will Feel
When the needle is inserted to draw blood, you may feel moderate pain, or only a prick or stinging sensation. Afterward, there may be some throbbing.
Why the Test is Performed
Your health care provider may order this test to help determine the cause of joint pain, stiffness, or swelling. The test may be done along with other tests, including:
A normal (negative) result means HLA-B27 is absent.
What Abnormal Results Mean
A positive test means HLA-B27 is present. It suggests a greater-than-average risk for developing or having certain autoimmune disorders. An autoimmune disorder is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue.
A positive result can help your provider make a diagnosis of a form of arthritis called spondyloarthritis. This kind of arthritis includes the following disorders:
- Ankylosing spondylitis
- Arthritis related to Crohn disease or ulcerative colitis
- Psoriatic arthritis (arthritis associated with psoriasis)
- Reactive arthritis
- Sacroiliitis (inflammation of the sacroiliac joint)
If there are symptoms or signs of an autoimmune disease, a positive HLA-B27 test may confirm the diagnosis. However, HLA-B27 is normally found in a small number of white people and does not always mean you have a disease.
Risks from having blood drawn are slight, but may include:
- Excessive bleeding
- Fainting or feeling light-headed
- Hematoma (blood accumulating under the skin)
- Infection (a slight risk any time the skin is broken)
Inman RD. The spondyloarthropathies. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 273.
Rudwaleit M, van der Heijde D, Landewé R, et al. The Assessment of SpondyloArthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann Rheum Dis. 2011;70:25. PMID: 21109520 www.ncbi.nlm.nih.gov/pubmed/21109520.
Reviewed By: Gordon A. Starkebaum, MD, Professor of Medicine, Division of Rheumatology, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.