HLA and HIV-1: heterozygote advantage and B*35-Cw*04 disadvantage

Science. 1999 Mar 12;283(5408):1748-52. doi: 10.1126/science.283.5408.1748.

Abstract

A selective advantage against infectious disease associated with increased heterozygosity at the human major histocompatibility complex [human leukocyte antigen (HLA) class I and class II] is believed to play a major role in maintaining the extraordinary allelic diversity of these genes. Maximum HLA heterozygosity of class I loci (A, B, and C) delayed acquired immunodeficiency syndrome (AIDS) onset among patients infected with human immunodeficiency virus-type 1 (HIV-1), whereas individuals who were homozygous for one or more loci progressed rapidly to AIDS and death. The HLA class I alleles B*35 and Cw*04 were consistently associated with rapid development of AIDS-defining conditions in Caucasians. The extended survival of 28 to 40 percent of HIV-1-infected Caucasian patients who avoided AIDS for ten or more years can be attributed to their being fully heterozygous at HLA class I loci, to their lacking the AIDS-associated alleles B*35 and Cw*04, or to both.

Publication types

  • Multicenter Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acquired Immunodeficiency Syndrome / genetics
  • Acquired Immunodeficiency Syndrome / immunology*
  • Adult
  • Alleles
  • Antigen Presentation
  • Cohort Studies
  • Disease Progression
  • Ethnicity
  • Genes, MHC Class I*
  • Genetic Predisposition to Disease
  • HIV Infections / genetics
  • HIV Infections / immunology*
  • HIV Long-Term Survivors / statistics & numerical data
  • HIV-1*
  • HLA Antigens / genetics
  • HLA-B Antigens / genetics*
  • HLA-C Antigens / genetics*
  • Heterozygote
  • Homozygote
  • Humans
  • Killer Cells, Natural / immunology
  • Loss of Heterozygosity
  • Proportional Hazards Models
  • Risk

Substances

  • HLA Antigens
  • HLA-B Antigens
  • HLA-C Antigens