HLA-B*57 and IFNL4-Related Polymorphisms Are Associated With Protection Against HIV-1 Disease Progression in Controllers

Identificador:  imarina:3661866

Handle: https://hdl.handle.net/20.500.11797/imarina3661866

Autors:  Dominguez-Molina, B; Tarancon-Diez, L; Hua, S; Abad-Molina, C; Rodriguez-Gallego, E; Machmach, K; Vidal, F; Tural, C; Moreno, S; Goni, MJ; de Arellano, ER; del Val, M; Gonzalez-Escribano, MF; Del Romero, J; Rodriguez, JDRC; Capa, L; Viciana, P; Alcami, J; Yu, XG; Walker, BD; Leal, M; Lichterfeld, M; Ruiz-Mateos, E

Resum:
Background. Human immunodeficiency virus type 1 (HIV-1) controllers maintain HIV-1 viremia at low levels (normally <2000 HIV-RNA copies/mL) without antiretroviral treatment. However, some HIV-1 controllers have evidence of immunologic progression with marked CD4+ T-cell decline. We investigated host genetic factors associated with protection against CD4+ T-cell loss in HIV-1 controllers. Methods. We analyzed the association of interferon-lambda 4 (IFNL4)-related polymorphisms and human leukocyte antigen (HLA)-B haplotypes within long-term nonprogressor HIV-1 controllers (LTNP-Cs; defined by maintaining CD4+ T-cells counts >500 cells/mm3 for more than 7 years after HIV-1 diagnosis) vs non-LTNP-Cs who developed CD4+ T-cell counts <500 cells/mm3. Both a Spanish study cohort (n = 140) and an international validation cohort (n = 914) were examined. Additionally, in a subgroup of individuals, HIV-1-specific T-cell responses and soluble cytokines were analyzed. Results. HLA-B∗57 was independently associated with the LTNP-C phenotype (odds ratio [OR], 3.056 [1.029-9.069]; P = .044 and OR, 1.924 [1.252-2.957]; P = .003) while IFNL4 genotypes represented independent factors for becoming non-LTNP-C (TT/TT, ss469415590; OR, 0.401 [0.171-0.942]; P = .036 or A/A, rs12980275; OR, 0.637 [0.434-0.934]; P = .021) in the Spanish and validation cohorts, respectively, after adjusting for sex, age at HIV-1 diagnosis, IFNL4-related polymorphisms, and different HLA-B haplotypes. LTNP-Cs showed lower plasma induced protein 10 (P = .019) and higher IFN-γ (P = .02) levels than the HIV-1 controllers with diminished CD4+ T-cell numbers. Moreover, LTNP-Cs exhibited higher quantities of interleukin (IL)2+CD57- and IFN-γ +CD57-HIV-1-specific CD8+ T cells (P = .002 and .041, respectively) than non-LTNP-Cs. Conclusions. We defined genetic markers able to segregate stable HIV-1 controllers from those who experience CD4+ T-cell decline. These findings allow for identification of HIV-1 controllers at risk for immunologic progression and provide avenues for personalized therapeutic interventions and precision medicine for optimizing clinical care of these individuals.