New England Journal of Medicine
Background From studies of genetic polymorphisms and the rate of progression from human immunodeficiency virus type 1 (HIV-1) infection to the acquired immunodeficiency syndrome (AIDS), it appears that the strongest susceptibility is conferred by the major-histocompatibility-complex (MHC) class I type HLA-B*35,Cw*04 allele. However, cytotoxic T-lymphocyte responses have been observed against HIV-1 epitopes presented by HLA-B*3501, the most common HLA-B*35 subtype. We examined subtypes of HLA-B*35 in five cohorts and analyzed the relation of structural differences between HLA-B*35 subtypes to the risk of progression to AIDS. Methods Genotyping of HLA class I loci was performed for 850 patients who seroconverted and had known dates of HIV-1 infection. Survival analyses with respect to the rate of progression to AIDS were performed to identify the effects of closely related HLAB* 35 subtypes with different peptide-binding specificities.
Results HLA-B*35 subtypes were divided into two groups according to peptide-binding specificity: the HLA-B*35-PY group, which consists primarily of HLAB* 3501 and binds epitopes with proline in position 2 and tyrosine in position 9; and the more broadly reactive HLA-B*35-Px group, which also binds epitopes with proline in position 2 but can bind several different amino acids (not including tyrosine) in position 9. The influence of HLA-B*35 in accelerating progression to AIDS was completely attributable to HLAB* 35-Px alleles, some of which differ from HLA-B*35- PY alleles by only one amino acid residue.
Conclusions This analysis shows that, in patients with HIV-1 infection, a single amino acid change in HLA molecules has a substantial effect on the rate of progression to AIDS. The different consequences of HLA-B*35-PY and HLA-B*35-Px in terms of disease progression highlight the importance of the epitope specificities of closely related class I molecules in the immune defense against HIV-1.
Gao, Xiaojiang; George W. Nelson; Peter Karacki; Maureen P. Martin; John Phair; Richard A. Kaslow; James J. Goedert; Susan Buchbinder; Keith Hoots; David Vlahov; Stephen J. O'Brien; and Mary Carrington. 2001. "Effect of a Single Amino Acid Change in MHC Class I Molecules on the Rate of Progression to AIDS." New England Journal of Medicine 344, (22): 1668-1675. http://nsuworks.nova.edu/cnso_bio_facarticles/794