Association of HLA profiles with early plasma viral load, CD4+ cell count and rate of progression to AIDS following acute HIV-1 infection. Multicenter AIDS Cohort Study.
BACKGROUND
Host genetic factors, such as HLA alleles, play an important role in mediating the course of HIV-1 disease progression through largely undefined mechanisms.


OBJECTIVE
To examine the association of HLA markers with HIV-1 RNA plasma viral load and other factors associated with course of disease progression in HIV-1 infection.


METHODS
A group of 139 HIV-1 seroconverters from the Multicenter AIDS Cohort Study had been typed for a variety of HLA markers. HIV-1 RNA plasma viral load was measured from frozen plasma specimens obtained approximately 9 months following seroconversion. CD4+ cell counts were available from the same study visit. Statistical analysis was performed using survival techniques and linear regression models to quantify the relative associations of an HLA score profile, HIV-1 RNA plasma viral load, CD4+ cell count and age with each other and with rate of progression to AIDS and death.


RESULTS
Cox proportional hazards models showed statistically significant differences in time to AIDS by HLA score profile category per unit increase [relative hazard (RH), 0.64; P < 0.0001], HIV-1 RNA plasma viral load per 10-fold increase (RH, 2.04; P = 0.0003), and CD4+ cell count per 100 cell (x 10(6)/l) increase (RH, 0.90; P = 0.02). Multivariate linear regression showed that viral load was 39% lower (P = 0.0001) for each unit increase in HLA score profile and 13% lower (P = 0.002) for each 100 cell (x 10(6)/l) increase in CD4+ cell count.


CONCLUSIONS
The means by which the HLA score profile influences the time to AIDS is probably through immunologic responses that affect the rate of HIV-1 replication, as manifested by the HIV-1 RNA plasma viral load during the first 6-12 months following acute infection.
Saah
A J
AJ
Department of Epidemiology, The Johns Hopkins School of Hygiene and Public Health, Baltimore, Maryland, USA.
Hoover
D R
DR
Weng
S
S
Carrington
M
M
Mellors
J
J
Rinaldo
C R
CR
Mann
D
D
Apple
R
R
Phair
J P
JP
Detels
R
R
O'Brien
S
S
Enger
C
C
Johnson
P
P
Kaslow
R A
RA
D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology* / Q000821:virology*; D000208:Acute Disease; D000328:Adult; D015415:Biomarkers; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D015331:Cohort Studies; D018450:Disease Progression; D005500:Follow-Up Studies; D006679:HIV Seropositivity; D015497:HIV-1 / Q000276:immunology; D006680:HLA Antigens / Q000276:immunology*; D006801:Humans; D016014:Linear Models; D008297:Male; D016016:Proportional Hazards Models; D012367:RNA, Viral; D019562:Viral Load
D015415:Biomarkers; D006680:HLA Antigens; D012367:RNA, Viral