HIV nephropathy and the Duffy antigen/receptor for Chemokines in African Americans.
OBJECTIVE
HIV nephropathy (HIVAN) is markedly racially biased in its distribution, occurring in about 10% of HIV infected African Americans according to some studies. Based upon previous laboratory and epidemiological studies, the Duffy promoter polymorphism, which occurs almost exclusively in individuals of African descent, has been postulated to be the predisposing factor. We aimed to explore that relationship by directly genotyping individuals with HIV nephropathy to determine the proportion homozygous for this mutation to test the hypothesis it was responsible for the genetic component of this disease. We anticipated that if the polymorphism was associated with HIV nephropathy all individuals would be homozygous for this mutation.


METHODS
Individuals with HIVAN proven on biopsy were identified from previous studies and a pre-existing clinical database. This diagnosis was confirmed by an experienced pathologist examining the biopsies in a blinded fashion. PCR and RFLP strategies were used on the biopsy samples to genotype for the Duffy promoter polymorphism. The cases were compared to a control population of HIV seronegative African Americans.


RESULTS
Twenty African American individuals with HIV nephropathy were successfully genotyped. Only nine were homozygous for the promoter mutation. Nine were heterozygous and two homozygous wild type. Furthermore, the frequency of the polymorphism did not differ from the background rate in the African American population (OR = 0.788 95% confidence intervals 0.378-1.64).


CONCLUSIONS
The Duffy promoter polymorphism was not disproportionately represented in persons with HIVAN calling into question any significant role in the pathogenesis of HIVAN.
Woolley
I J
IJ
Department of Medicine, Case Western Reserve University School of Medicine, MetroHealth Medical Center, Cleveland, Ohio, USA. ianwoolley@hotmail.com
Kalayjian
R
R
Valdez
H
H
Hamza
N
N
Jacobs
G
G
Lederman
M M
MM
Zimmerman
P A
PA
D016263:AIDS-Associated Nephropathy / Q000208:ethnology / Q000235:genetics* / Q000473:pathology; D000328:Adult; D000953:Antigens, Protozoan; D044383:Black People / Q000235:genetics*; D002352:Carrier Proteins / Q000032:analysis*; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007668:Kidney / Q000473:pathology*; D008297:Male; D011110:Polymorphism, Genetic; D011401:Promoter Regions, Genetic; D015800:Protozoan Proteins; D011956:Receptors, Cell Surface / Q000032:analysis*; D012189:Retrospective Studies; D017422:Sequence Analysis, DNA; D014481:United States / Q000453:epidemiology; D001741:Black or African American
D000953:Antigens, Protozoan; D002352:Carrier Proteins; C066001:Duffy antigen binding protein, Plasmodium; D015800:Protozoan Proteins; D011956:Receptors, Cell Surface