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Life sciences · Journal article
Journal of Clinical Care and Medical Advancement · September 26, 2026
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The human leukocyte antigen (HLA) system shapes antigen presentation, alloimmune recognition and variation in immune responses. African populations harbour extensive HLA diversity, but remain underrepresented in high-resolution reference datasets and international donor resources, constraining the clinical interpretation and application of this diversity. This review examines the relevance of African HLA variation to transfusion medicine, transplantation, infectious-disease immunity, vaccination and pharmacogenomics. In transfusion practice, HLA alloimmunisation contributes to immune platelet transfusion refractoriness and may complicate the identification of compatible platelet products. In haematopoietic stem-cell and solid-organ transplantation, population-specific HLA frequencies and haplotypes influence donor matching, while HLA antibodies and donor-specific antibodies are important determinants of compatibility and transplant outcomes. African studies of malaria, HIV, tuberculosis and vaccine responses further demonstrate associations between HLA variation and pathogen-specific immunity, disease susceptibility or control, and variation in vaccine-induced antibody responses. Pharmacogenomic studies illustrate an additional clinical application, although evidence for several actionable HLA–drug associations remain limited across many African populations. Collectively, these findings highlight the need for population-resolved HLA datasets linked to clinical and immunological phenotypes. We propose an integrated African HLA framework connecting high-resolution population characterization with histocompatibility services, antibody testing, HLA-typed platelet and stem-cell donor resources, clinically annotated biobanks, functional immunology, pathogen–HLA–epitope studies and pharmacogenomic evidence. Strengthening these interconnected resources could support safer transfusion, improved transplantation, population-informed vaccine research, pharmacogenomic implementation and the development of emerging cellular therapies in African settings