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HLA ‐ Bw4 identifies a population of HIV ‐infected patients with an increased capacity to control viral replication after structured treatment interruption
Author(s) -
Stern M,
Czaja K,
Rauch A,
Rickenbach M,
Günthard H F,
Battegay M,
Fellay J,
Hirschel B,
Hess C
Publication year - 2012
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/j.1468-1293.2012.01019.x
Subject(s) - viral load , human leukocyte antigen , medicine , viral replication , immunology , genotype , allele , population , virology , epitope , antibody , antigen , human immunodeficiency virus (hiv) , gene , virus , biology , genetics , environmental health
Objectives After structured treatment interruption ( STI ) of treatment for HIV ‐1, a fraction of patients maintain suppressed viral loads. Prospective identification of such patients might improve HIV ‐1 treatment, if selected patients are offered STI . Methods We analysed the effect of previously identified genetic modulators of HIV ‐1 disease progression on patients’ ability to suppress viral replication after STI . Polymorphisms in the genes killer cell immunoglobulin‐like receptor 3DLI ( KIR3DL1 )/ KIR3DS1 , human leucocyte antigen B ( HLA ‐ B ) and HLA Complex P5 ( HCP5 ), and a polymorphism affecting HLA ‐ C surface expression were analysed in 130 S wiss HIV C ohort S tudy patients undergoing STI . Genotypes were correlated with viral load levels after STI . Results We observed a statistically significant reduction in viral load after STI in carriers of HLA ‐ B alleles containing either the Bw480Thr or the Bw480Ile epitope (mean adjusted effect on post‐ STI viral load: −0.82 log HIV ‐1 RNA copies/ml, P < 0.001; and −1.12 log copies/ml, P < 0.001, respectively). No significant effects were detected for the other polymorphisms analysed. The likelihood of being able to control HIV ‐1 replication using a prespecified cut‐off (viral load increase < 1000 copies/ml) increased from 39% in Bw4 ‐negative patients to 53% in patients carrying Bw4 ‐ 80Thr , and to 65% in patients carrying Bw4 ‐80Ile ( P = 0.02). Conclusions These data establish a significant impact of HLA ‐ Bw4 on the control of viral replication after STI .