AIDSWEEKLY Plus; Monday, July 19, 2004
Staff Medical Writers

According to a study from England, "Polymorphism amongst the human leucocyte antigen (HLA) class II genes could influence antigen presentation and the ability to control human immunodeficiency virus (HIV)-1 by modulating the virus specific CD4 immune response. To examine the effect of such polymorphisms on disease progression, we studied a cohort of 46 HIV-1 infected long-term non-progressors (LTNPs), 87 intermediate progressors (IPs) and 26 rapid progressors."

"Kaplan-Meier survival analysis of all patients in the cohort on time to a CD4 count less than 350 cells/uL, showed a trend for a slower rate of CD4 decline in patients with, compared to those without, the DRB1*15-DQB1*06 haplotype (hazard ratio (HR) 0.69, 95% Cl 0.46-1.01, P=0.06).

"A similar effect was not observed with the DRB1*13-DQB1*06 haplotype (HR 1.18, 95% Cl 0.75-1.88, P=0.46)," A. Vyakarnam and coworkers reported, "but was observed when DQB1*06 alleles were considered irrespective of their DR association (HR 0.74, 95% Cl 0.52-1.05, P=0.06). Major HLA-DQ6 alleles encode aspartate (Asp) at position 57 on the DQbeta chain, a phenotype associated with protection from other immune disorders."

"We therefore examined the frequency of all DQbeta57 Asp+ alleles, but could not detect a significant effect on the rate of CD4 decline. To examine whether the genotype associated with slower CD4 decline was over-represented in patients with a slow rate of disease progression, we conducted a categorical analysis of a subset of patients with an extended follow-up of 14+ years.

"We found a higher proportion of LTNPs at 14+ years possessed the DRB1*15-DQB1*06 haplotype compared to IPs at 14+ years (38.46 versus 18.18%)," the authors continued, "although this difference did not reach statistical significance. When DQB1*06 alleles irrespective of their DR association were considered, the protective effect was greater (76.9%, LTNPs versus 18.18%, IPs, P=0.04)."

Scientists concluded, "Our results highlight the potential protective effect of HLA DQB1*06 alleles on the course of HIV disease."

Vyakarnam and colleagues published their study in Immunology (Possession of human leucocyte antigen DQ6 alleles and the rate of CD4 T-cell decline in human immunodeficiency virus-1 infection. Immunology. 2004 May;112(1):136-42.

For more information, contact A. Vyakarnam, University London Kings College, GKT School of Medicine, Department Infection Diseases, Guys Campus, 2nd Floor, New Guys House, London SE9 1RT, England.

Publisher contact information for the journal Immunology is: Blackwell Publishing Ltd., 9600 Garsington Rd., Oxford OX4 2DG, Oxon, England.

The information in this article comes under the major subject areas of HIV/AIDS, Immunology, Pathogenesis and Survival & Mortality.

This article was prepared by AIDS Weekly editors from staff and other reports.

Reference

Vyakarnam A, Sidebottom D, Murad S, "Possession of human leucocyte antigen DQ6 alleles and the rate of CD4 T-cell decline in human immunodeficiency virus-1 infection", Immunology. 2004 May;112(1):136-42.

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