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Frequent HLA Class I Alleles are associated with higher
viral load among hiv type 1 seroconverters in Thailand.
Journal of AIDS 2004;37(2):1318-1323.
Nguyen L, Chaowanachan T, Vanichseni S, McNicholl JM, Mock PA, Nelson
R, Hodge TW, Van Griensven F, Sangkum U, Choopanya K, Mastro TD, Tappero
JW, Hu DJ.
Abstract
The loss of viral control by the host may be due to the evolution of viruses
with mutations that limit presentation by human leukocyte antigen (HLA) to
cytotoxic T cells. The authors hypothesized that the consequence of such
evolution might be that persons with common HLA class I alleles would be
less able to control viremia, on average, than would those with rare alleles.
HLA class I typing was completed for 128 injection drug users who seroconverted
in a prospective cohort study in Bangkok, Thailand. Logistic regression was
used to model viral load (greater than or equal to the median) at 9 and 12
months after seroconversion with an HLA score that profiled the relative
prevalence of each individual's alleles. At 12 months after seroconversion,
injection drug users with the most common HLA alleles (highest quartile HLA
score) had an almost 4-fold increased risk for higher viral load (>/=32,055
copies/mL) than injection drug users with less common HLA alleles (adjusted
odds ratio, 3.92; 95% confidence interval, 1.3-11.8). These findings support
the importance of frequency-dependent effects of host genes on HIV type 1
evolution in different populations and suggest that HLA-driven viral evolution
critically influences control of viremia in early HIV type 1 infection.