title: FcgammaRIIa genotype predicts progression of HIV infection.
abstract: Polymorphisms in FcgammaR genes are associated with susceptibility to or severity of a number of autoimmune and infectious diseases. We found that HIV-infected men in the Multicenter AIDS Cohort Study with the FcgammaRIIa RR genotype progressed to a CD4(+) cell count of <200/mm(3) at a faster rate than individuals with the RH or HH genotypes (relative hazard = 1.6; p = 0.0001). However, progression to AIDS (using the broad definition of either a CD4(+) cell count <200/mm(3) or development of an AIDS-defining illness) was less impacted by FcgammaRIIa genotype, largely because HH homozygotes had an increased risk of Pneumocystis jiroveci pneumonia as an AIDS-defining illness. We also showed that chronically infected subjects develop a substantial anti-gp120-specific IgG2 response. Moreover, HIV-1 immune complexes are more efficiently internalized by monocytes from HH subjects compared with RR subjects, likely because of the presence of IgG2 in the complexes. Finally, the FcgammaRIIIa F/V gene polymorphism was not associated with progression of HIV infection, but, as demonstrated previously, did predict the risk of Kaposi's sarcoma. These results demonstrate the importance of FcgammaRs in AIDS pathogenesis and point toward a critical role for interactions between FcgammaRs and immune complexes in disease progression.
authors.affiliation: Division of Infectious Diseases, Department of Medicine, University of California, Irvine School of Medicine, Irvine, CA 92697, USA. dnfortha@uci.edu
authors.forename: Donald N
authors.initials: DN
authors.lastname: Forthal
authors.forename: Gary
authors.initials: G
authors.lastname: Landucci
authors.forename: Jay
authors.initials: J
authors.lastname: Bream
authors.forename: Lisa P
authors.initials: LP
authors.lastname: Jacobson
authors.forename: Tran B
authors.initials: TB
authors.lastname: Phan
authors.forename: Benjamin
authors.initials: B
authors.lastname: Montoya
mesh_terms: D000328:Adult; D015703:Antigens, CD / Q000235:genetics*; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology / Q000821:virology; D015331:Cohort Studies; D018450:Disease Progression; D005838:Genotype; D006678:HIV / Q000276:immunology; D015658:HIV Infections / Q000175:diagnosis* / Q000235:genetics* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D017452:Receptors, IgG / Q000235:genetics*; D012307:Risk Factors
chemical_list: D015703:Antigens, CD; C080568:Fc gamma receptor IIA; D017452:Receptors, IgG