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Association of HLA types A1-B8-DR3 and B27 with rapid and slow progression of HIV disease

A J McNeil1, P L Yap, S M Gore

  • 1Department of Applied Mathematics, University of Zurich, Switzerland.

QJM : Monthly Journal of the Association of Physicians
|March 1, 1996
PubMed

Insights

Human Leukocyte Antigen (HLA) types A1-B8-DR3 and B27 impact Human Immunodeficiency Virus (HIV) disease progression. HLA A1-B8-DR3 is linked to faster disease progression and CD4+ T-cell loss in HIV patients.

Area of Science:

  • Immunogenetics
  • Virology
  • Clinical Medicine

Background:

  • Human Leukocyte Antigen (HLA) genes play a crucial role in immune response and disease susceptibility.
  • Specific HLA types have been associated with varying rates of Human Immunodeficiency Virus (HIV) infection progression.
  • Understanding these associations can inform prognostic assessments and potential therapeutic strategies.

Purpose of the Study:

  • To investigate the relationship between specific HLA types (A1-B8-DR3 and B27) and the clinical progression of HIV disease.
  • To determine the association of these HLA types with the rate of CD4+ lymphocyte count decline in HIV-positive individuals.
  • To analyze the impact of HLA A1-B8-DR3 and B27 on progression to Centers for Disease Control and Prevention (CDC) stage IV, Acquired Immunodeficiency Syndrome (AIDS), and mortality.

Main Methods:

  • Prospective cohort study of 692 HIV-positive patients from 1985 to 1994.
  • Retrospective determination of seroconversion times for a subgroup of 313 patients.
  • HLA typing performed on 262 patients; proportional hazards analysis and random effects growth curve models used for statistical analysis of disease progression and CD4+ cell count changes.

Main Results:

  • HLA type A1-B8-DR3 was significantly associated with increased relative risks for progression to CDC stage IV (1.9-fold), AIDS (3.1-fold), and death (3.7-fold) after HIV seroconversion.
  • Patients with HLA A1-B8-DR3 exhibited a more rapid loss of CD4+ T-cell count and CD4+ percentage.
  • HLA type B27 was associated with slower progression to CDC stage IV (0.3-fold) and slower loss of CD4+ markers, though events for B27 were too rare for mortality and AIDS analyses.

Conclusions:

  • Specific HLA genotypes, particularly A1-B8-DR3, are strong predictors of more rapid HIV disease progression and immune deterioration.
  • HLA type B27 appears to be associated with a slower disease course in HIV infection.
  • These findings highlight the influence of host genetics, specifically HLA type, on the clinical trajectory of HIV/AIDS.

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