The potential contribution of HLA-A alleles to viremic control in chronic HIV type 1 (HIV-1) infection has been relatively understudied compared with HLA-B. In these studies, we show that HLA-A*7401 is associated with favorable viremic control in extended southern African cohorts of >2100 C-clade–infected subjects. We present evidence that HLA-A*7401 operates an effect that is independent of HLA-B*5703, with which it is in linkage disequilibrium in some populations, to mediate lowered viremia. We describe a novel statistical approach to detecting additive effects between class I alleles in control of HIV-1 disease, highlighting improved viremic control in subjects with HLA-A*7401 combined with HLA-B*57. In common with HLA-B alleles that are associated with effective control of viremia, HLA-A*7401 presents highly targeted epitopes in several proteins, including Gag, Pol, Rev, and Nef, of which the Gag epitopes appear immunodominant. We identify eight novel putative HLA-A*7401–restricted epitopes, of which three have been defined to the optimal epitope. In common with HLA-B alleles linked with slow progression, viremic control through an HLA-A*7401–restricted response appears to be associated with the selection of escape mutants within Gag epitopes that reduce viral replicative capacity. These studies highlight the potentially important contribution of an HLA-A allele to immune control of HIV infection, which may have been concealed by a stronger effect mediated by an HLA-B allele with which it is in linkage disequilibrium. In addition, these studies identify a factor contributing to different HIV disease outcomes in individuals expressing HLA-B*5703.
This work was supported by the United Kingdom Medical Research Council (to P.C.M.), the Oxford Radcliffe Hospitals Medical Research Fund (to P.C.M), National Institutes of Health Grant 2RO1AI46995, National Institute of Allergy and Infectious Diseases Contract HHSN272200900045C, the South African AIDS Vaccine Initiative, the Wellcome Trust (to A.L. and P.J.R.G.), the National Cancer Institute, National Institutes of Health Contract HHSN261200800001E, and the Intramural Research Program of the National Institutes of Health, National Cancer Institute, Center for Cancer Research. P.J.R.G. is an Elizabeth Glaser Pediatric AIDS Foundation Scientist.
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The online version of this article contains supplemental material.
- Received November 8, 2010.
- Accepted March 4, 2011.