Immune predispositions for cytomegalovirus retinitis in AIDS. The HNRC Group.
CMV retinitis develops in approximately 28-35% of all AIDS patients at later stages of disease, often leading to blindness. To determine whether the subset of AIDS patients who developed CMV retinitis (CMV-R) were immunologically predisposed, T cell proliferation responses to CMV were examined prospectively in an HIV infected, HLA typed, longitudinal study population. Individuals who developed CMV-R had significantly lower T cell proliferation responses to CMV, both early and late in disease, compared to CD4 matched controls who have not developed CMV-R. Since HLA proteins influence T-cell recognition, phenotypes of 21 CMV-R patients were examined to determine whether certain HLA alleles were associated with low immune response and predisposed AIDS patients to CMV-R. HLA DR7 and B44 were at increased (nearly twice the expected) frequency in those with CMV-R. The combined association of either B44, 51 or DR7 with CMV-R was highly significant (P = .008, relative risk of CMV-R = 15) with correction for multiple comparisons. Low immune responses were twice as frequent in those with (61%) compared to those without (30%) predisposing alleles. Thus, AIDS patients with immunogenetically related hyporesponsiveness to CMV antigens may be at increased risk of retinitis.
Schrier
R D
RD
Department of Pathology, University of California, San Diego, La Jolla 92093, USA.
Freeman
W R
WR
Wiley
C A
CA
McCutchan
J A
JA
D000163:Acquired Immunodeficiency Syndrome / Q000150:complications* / Q000276:immunology*; D017726:Cytomegalovirus Retinitis / Q000209:etiology* / Q000276:immunology; D005260:Female; D005787:Gene Frequency; D006680:HLA Antigens / Q000235:genetics*; D015235:HLA-B Antigens / Q000235:genetics; D059948:HLA-B44 Antigen; D059949:HLA-B51 Antigen; D015809:HLA-DR7 Antigen / Q000235:genetics; D006801:Humans; D007108:Immune Tolerance; D008137:Longitudinal Studies; D008213:Lymphocyte Activation; D008297:Male; D011446:Prospective Studies; D012307:Risk Factors; D013601:T-Lymphocytes / Q000276:immunology
D006680:HLA Antigens; D015235:HLA-B Antigens; D059948:HLA-B44 Antigen; D059949:HLA-B51 Antigen; D015809:HLA-DR7 Antigen