Host genetics and viral load in primary HIV-1 infection: clear evidence for gene by sex interactions

Hum Genet. 2014 Sep;133(9):1187-97. doi: 10.1007/s00439-014-1465-x. Epub 2014 Jun 27.

Abstract

Research in the past two decades has generated unequivocal evidence that host genetic variations substantially account for the heterogeneous outcomes following human immunodeficiency virus type 1 (HIV-1) infection. In particular, genes encoding human leukocyte antigens (HLA) have various alleles, haplotypes, or specific motifs that can dictate the set-point (a relatively steady state) of plasma viral load (VL), although rapid viral evolution driven by innate and acquired immune responses can obscure the long-term relationships between HLA genotypes and HIV-1-related outcomes. In our analyses of VL data from 521 recent HIV-1 seroconverters enrolled from eastern and southern Africa, HLA-A*03:01 was strongly and persistently associated with low VL in women (frequency = 11.3 %, P < 0.0001) but not in men (frequency = 7.7 %, P = 0.66). This novel sex by HLA interaction (P = 0.003, q = 0.090) did not extend to other frequent HLA class I alleles (n = 34), although HLA-C*18:01 also showed a weak association with low VL in women only (frequency = 9.3 %, P = 0.042, q > 0.50). In a reduced multivariable model, age, sex, geography (clinical sites), previously identified HLA factors (HLA-B*18, B*45, B*53, and B*57), and the interaction term for female sex and HLA-A*03:01 collectively explained 17.0 % of the overall variance in geometric mean VL over a 3-year follow-up period (P < 0.0001). Multiple sensitivity analyses of longitudinal and cross-sectional VL data yielded consistent results. These findings can serve as a proof of principle that the gap of "missing heritability" in quantitative genetics can be partially bridged by a systematic evaluation of sex-specific associations.

Publication types

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

MeSH terms

  • Adult
  • Africa, Eastern
  • Africa, Western
  • Alleles
  • Cross-Sectional Studies
  • Female
  • Genetic Variation*
  • HIV Infections / genetics*
  • HIV Infections / immunology
  • HIV Infections / virology
  • HIV Seropositivity
  • HIV-1 / immunology*
  • HLA-A Antigens / genetics*
  • HLA-A Antigens / immunology
  • HLA-B Antigens / genetics*
  • HLA-B Antigens / immunology
  • HLA-C Antigens / genetics*
  • HLA-C Antigens / immunology
  • Haplotypes
  • Humans
  • Linkage Disequilibrium
  • Longitudinal Studies
  • Male
  • Multivariate Analysis
  • Quantitative Trait, Heritable
  • Sex Factors
  • Viral Load
  • Young Adult

Substances

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