Progression of HIV to AIDS: a Protective Role for HLA-B27?

HLA-B27 is known for its strong association with inflammatory spondyloarthropathies (SpA), a group of rheumatic diseases. Apart from playing its role in the onset of these inflammatory diseases, HLAB27 is so ubiquitous in the world that the rrying of this gene must have also have an advantage. There are some indications that a beneficial effect an be found as a less severe course of viral infections among B27-carriers. he literature on this subject was eviewed and revealed a favorable course of infection with influenza virus, erpes simplex type 2 virus, Epstein- arr virus and, even more interesting, a protective effect of HLA-B27 in the progression of HIV infections. The ourse of HIV infection differs among individuals and is thought to be partly related to host-factor variability, reflecting broad genetic heterogeneity. he polymorphic human leukocyte antigens (HLA) are herein analyzed intensively with respect to this relationship. Cytotoxic T mphocyte (CTL) responses, activated by HLA antigen presentation, are implicated in the control of HIV replication. An immunological explanation for the protective role for HLA B27 in HIV disease is that B27+ patients have a specific and strong CTL response against the p24 epitope, a conservative HIV protein that does not easily mutate. Some HLA genes seen in ong-term non-progressors (LTNP) (>10 years disease free) are associated with a favorable prognosis. One of thealleles found predominantly in LTNPs is HLA-B27. More genetic factors seem to influence disease progression in HIV infections. Therefore, it would be interesting to further explore the influence of the genetic make up of these HIV-infected individuals. Knowledge of the immunogenetic profile might give clues for the individual course of the HIV infection, may influence the development of drug- esistant viruses and will possibly lead to a tailored therapeutic strategy in IV-infected persons.