Host genetic influences on highly active antiretroviral therapy efficacy and AIDS-free survival.
We studied the influence of AIDS restriction genes (ARGs) CCR5-Delta32, CCR2-64I, SDF1-3'A, IL10-5'A, CX3CR1-V249I, CX3CR1-T280M, and MDR1-C3435T and haplotypes of the CCR5 P1 promoter and RANTES variants -403A, In1.1C, 3'222C, and -28G among HIV-1 infected patients on highly active antiretroviral therapy (HAART) in the Multicenter AIDS Cohort Study (MACS) and the Multicenter Hemophilia Cohort Study (MHCS). Our results indicate that several ARGs also influence therapy efficacy (ie, the success in viral suppression) and subsequent progression to AIDS while on HAART. CCR5-Delta32 decreased time to viral suppression (<200 HIV RNA copies/mL, relative hazard [RH]=1.40; P=0.008) and was protective against AIDS (RH=0.11; P=or<0.0001), whereas the CCR5 P1 haplotype was associated with delayed viral suppression (RNA<50 copies/mL, odds ratio [OR]=0.65; P=0.03) and accelerated time to AIDS (RH=2.68; P=0.02). SDF1-3'A reduced viral suppression (OR=0.61; P=0.02) and accelerated AIDS (RH=3.18; P=0.009). Accelerated AIDS progression was also observed with the RANTES haplotype carrying RANTES-IN1.1C and RANTES-3'222C (P=0.005 to 0.007). In contrast, the RANTES haplotype H1, which lacks suspected deleterious single-nucleotide polymorphisms, was protective against AIDS. CX3CR1-V249I seemed to accelerate viral suppression (RNA<50 copies/mL, OR=1.27; P=0.01). ARG influence after HAART suggests residual HIV-1 replication, and spread continues even in patients successfully suppressing detectable viral RNA.
Hendrickson
Sher L
SL
Laboratory of Genomic Diversity, National Cancer Institute, Frederick, MD 21702-1201, USA.
Jacobson
Lisa P
LP
Nelson
George W
GW
Phair
John P
JP
Lautenberger
James
J
Johnson
Randall C
RC
Kingsley
Lawrence
L
Margolick
Joseph B
JB
Detels
Roger
R
Goedert
James J
JJ
O'Brien
Stephen J
SJ
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000235:genetics*; D000163:Acquired Immunodeficiency Syndrome / Q000235:genetics*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D018946:Chemokine CCL5 / Q000235:genetics; D015331:Cohort Studies; D018450:Disease Progression; D005838:Genotype; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D008297:Male; D020641:Polymorphism, Single Nucleotide; D044465:White People
D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D018946:Chemokine CCL5