HLA and HIV-1: Heterozygote Advantage and B*35-Cw*04 Disadvantage
A selective advantage against infectious disease associated with increased heterozygosity at the human major histocompatibility complex [human leukocyte antigen (HLA) class I and class II] is believed to play a major role in maintaining the extraordinary allelic diversity of these genes. Maximum HLA heterozygosity of class I loci (A, B, and C) delayed acquired immunodeficiency syndrome (AIDS) onset among patients infected with human immunodeficiency virus-type 1 (HIV-1), whereas individuals who were homozygous for one or more loci progressed rapidly to AIDS and death. The HLA class I alleles B*35 and Cw*04 were consistently associated with rapid development of AIDS-defining conditions in Caucasians. The extended survival of 28 to 40 percent of HIV-1-infected Caucasian patients who avoided AIDS for ten or more years can be attributed to their being fully heterozygous at HLA class I loci, to their lacking the AIDS-associated alleles B*35 and Cw*04, or to both.
Carrington, Mary; George W. Nelson; Maureen P. Martin; Teri Kissner; David Vlahov; James J. Goedert; Richard A. Kaslow; Susan Buchbinder; Keith Hoots; and Stephen J. O'Brien. 1999. "HLA and HIV-1: Heterozygote Advantage and B*35-Cw*04 Disadvantage." Science 283, (5408): 1748-1752. http://nsuworks.nova.edu/cnso_bio_facarticles/660