From the SAA page:
"First, hla-b27 is a perfectly normal gene found in 8% of the Caucasian population. Generally speaking, no more than 2% of people born with this gene will eventually get spondylitis.
Secondly, it is important to note that the hla-b27 test is
not a diagnostic test for AS. (emphasis added) Also, the association between AS and hla-b27 varies in different ethnic and racial groups. It can be a very strong indicator in that over 95% of people in the Caucasion population who have AS test hla-b27 positive. However, only 50% of African American patients with AS possess hla-b27 , and it is close to 80% among AS patients from Mediterranean countries."
http://www.spondylitis.org/about/as_diag.aspx?PgSrch=hla-b27The presence of HLA-B27 can help strengthen the case for an AS diagnosis, but the absence of it should not be a mark against the diagnosis.