HLA-B*57 versus HLA-B*81 in HIV-1 infection: slow and steady wins the race?

J Virol. 2013 Apr;87(7):4043-51. doi: 10.1128/JVI.03302-12. Epub 2013 Jan 30.


Two human leukocyte antigen (HLA) variants, HLA-B*57 and -B*81, are consistently known as favorable host factors in human immunodeficiency virus type 1 (HIV-1)-infected Africans and African-Americans. In our analyses of prospective data from 538 recent HIV-1 seroconverters and cross-sectional data from 292 subjects with unknown duration of infection, HLA-B*57 (mostly B*57:03) and -B*81 (exclusively B*81:01) had mostly discordant associations with virologic and immunologic manifestations before antiretroviral therapy. Specifically, relatively low viral load (VL) in HLA-B*57-positive subjects (P ≤ 0.03 in various models) did not translate to early advantage in CD4(+) T-cell (CD4) counts (P ≥ 0.37). In contrast, individuals with HLA-B*81 showed little deviation from the normal set point VL (P > 0.18) while maintaining high CD4 count during early and chronic infection (P = 0.01). These observations suggest that discordance between VL and CD4 count can occur in the presence of certain HLA alleles and that effective control of HIV-1 viremia is not always a prerequisite for favorable prognosis (delayed immunodeficiency). Of note, steady CD4 count associated with HLA-B*81 in HIV-1-infected Africans may depend on the country of origin, as observations differed slightly between subgroups enrolled in southern Africa (Zambia) and eastern Africa (Kenya, Rwanda, and Uganda).

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Africa, Eastern
  • Analysis of Variance
  • Black People
  • CD4-Positive T-Lymphocytes / immunology
  • Cell Count
  • Cross-Sectional Studies
  • HIV Infections / immunology*
  • HIV-1*
  • HLA-B Antigens / metabolism*
  • Host-Derived Cellular Factors / metabolism*
  • Humans
  • Immunophenotyping
  • Prospective Studies
  • Sequence Analysis, DNA
  • Viral Load / immunology*
  • Zambia


  • HLA-B Antigens
  • HLA-B57 antigen
  • Host-Derived Cellular Factors