X chromosomal variation is associated with slow progression to AIDS in HIV-1-infected women.
AIDS has changed from a mostly male-specific health problem to one that predominantly affects females. Although sex differences in HIV-1 susceptibility are beyond doubt, the extent to which sex affects the onset and progression of AIDS has remained elusive. Here, we provide evidence for an influence of X chromosomal variation on the course of retroviral infection, both in HIV-1-infected patients and in the rhesus macaque model of AIDS. A two-stage, microsatellite-based GWAS of SIV-infected monkeys revealed MHC class I markers and a hitherto-unknown X chromosomal locus as being associated with a nominal score measuring progression to AIDS (Fisher's exact p < 10(-6)). The X chromosomal association was subsequently confirmed in HIV-1-infected patients with published SNP genotype data. SNP rs5968255, located at human Xq21.1 in a conserved sequence element near the RPS6KA6 and CYLC1 genes, was identified as a significant genetic determinant of disease progression in females (ANOVA p = 8.8 x 10(-5)), but not in males (p = 0.19). Heterozygous female carriers of the C allele showed significantly slower CD4 cell decline and a lower viral load at set point than TT homozygous females and than males. Inspection of HapMap revealed that the CT genotype is significantly more frequent among Asians than among Europeans or Africans. Our results suggest that, in addition to the individual innate and adaptive immunity status, sex-linked genetic variation impacts upon the rate of progression to AIDS. Elucidating the mechanisms underlying this sex-specific effect will promote the development of antiretroviral therapies with high efficacy in both sexes.
Siddiqui
Roman A
RA
Genome Analysis, Leibniz Institute for Age Research-Fritz Lipmann Institute, Jena, Germany. rsidd@fli-leibniz.de
Sauermann
Ulrike
U
Altmüller
Janine
J
Fritzer
Elfriede
E
Nothnagel
Michael
M
Dalibor
Nina
N
Fellay
Jacques
J
Kaup
Franz-Josef
FJ
Stahl-Hennig
Christiane
C
Nürnberg
Peter
P
Krawczak
Michael
M
Platzer
Matthias
M
D000163:Acquired Immunodeficiency Syndrome / Q000235:genetics / Q000276:immunology / Q000821:virology; D000483:Alleles; D041321:Chromosomes, Human, X; D018450:Disease Progression; D005260:Female; D005787:Gene Frequency; D014644:Genetic Variation; D015658:HIV Infections / Q000235:genetics* / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000235:genetics / Q000276:immunology; D006579:Heterozygote; D006801:Humans; D008297:Male; D010641:Phenotype; D020641:Polymorphism, Single Nucleotide; D012737:Sex Factors
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