title: Association between maternal and infant class I and II HLA alleles and of their concordance with the risk of perinatal HIV type 1 transmission.
abstract: We aimed to investigate the influence of class I and class II HLA specificities and of the concordance between maternal and infant HLA on vertical HIV-1 transmission. HLA typing of samples from mothers and infants enrolled in the Ariel study, a perinatal HIV-1 transmission cohort including 203 mother-infant pairs, was performed by serological and molecular methods. HLA effects were evaluated alone and by multivariate modeling considering also other known predictors of perinatal HIV-1 transmission (maternal viral load, antiretroviral therapy, duration of rupture of membranes, and histological chorioamnionitis). Modest associations were seen with specific HLA markers (increased risk with infant B67 and B58 and maternal DR1; decreased risk with maternal B12), but these were not statistically significant after adjusting for multiple comparisons. Mother-infant concordance at any class I locus was a strong predictor of transmission (odds ratio [OR], 4.16; p = 0.028). Transmission was not associated with class II concordance. Class I HLA concordance retained its importance after adjusting for maternal viral load, antiretroviral therapy, duration of rupture of membranes or histological chorioamnionitis. In multivariate modeling, only class I concordance (OR, 3.59; p = 0.069) and chorioamnionitis (OR, 3.79; p = 0.030) were retained as independent predictors of transmission. HLA alleles, and in particular the class I concordance between maternal and neonatal HLA, may regulate the risk of perinatal HIV-1 transmission.
authors.affiliation: Clinical and Molecular Epidemiology Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina 45110, Greece.
authors.forename: Anastasia
authors.initials: A
authors.lastname: Polycarpou
authors.forename: Christos
authors.initials: C
authors.lastname: Ntais
authors.forename: Bette T
authors.initials: BT
authors.lastname: Korber
authors.forename: Henry A
authors.initials: HA
authors.lastname: Elrich
authors.forename: Robert
authors.initials: R
authors.lastname: Winchester
authors.forename: Paul
authors.initials: P
authors.lastname: Krogstad
authors.forename: Steven
authors.initials: S
authors.lastname: Wolinsky
authors.forename: Timothy
authors.initials: T
authors.lastname: Rostron
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Rowland-Jones
authors.forename: Arthur J
authors.initials: AJ
authors.lastname: Ammann
authors.forename: John P A
authors.initials: JP
authors.lastname: Ioannidis
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000188:drug therapy / Q000635:transmission* / Q000821:virology; D000483:Alleles; D005260:Female; D005805:Genes, MHC Class I; D005802:Genes, MHC Class II; D015497:HIV-1; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D012306:Risk; D019562:Viral Load