Dissertation
Dissertation > Medicine, health > Internal Medicine > Infectious disease > Viral infections > Acquired Immune Deficiency Syndrome ( AIDS AIDS)

The Association between HLA Typing and Disease Progression of HIV/AIDS and the Effect of cART

Author GuiYang
Tutor LiTaiSheng
School Beijing Union Medical College
Course Clinical
Keywords HIV-1 HLA disease progress immune reconstitution cART
CLC R512.91
Type PhD thesis
Year 2012
Downloads 39
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[Objective] There had been several studies about the association of HLA typing and AIDS which discovered some HLA typings related to disease progression. In this study, we attempted to confirm these findings in Chinese population and explored the association between the HLA typing and the effect of cART.[Methods] We recruited874HIV infected patients from three cohort study and made a count on gender, nationality, date of birth, the way of infection, probable time of infection, CD4level and viral load on baseline. We followed up CD4level and viral load after cART for48weeks. HLA-A, HLA-B, HLA-C, HLA-DRB1alleles were extracted by PCR-SBT. We analyzed the gene frequency of HLA alleles in HIV/AIDS patients. According to the time (T) from HIV seroconversion to AIDS,525patients were divided into two groups:RP group were defined if T<5years and all others were defined as NRP group. The allele distribution was compared in order to evaluate HLA polymorphism among different HIV/AIDS disease progression. After cART for48weeks,529patients were divided into the group of completely virology suppression and the group of incompletely virology suppression according to the viral load above or below50cps/ml. On basis of the increase of CD4level greater or less than100cells/μl,379patients was divided into two groups. The allele distribution was compared in order to assess the effect of HLA polymorphism on response to cART.[Results] HLA-A*02(41.38%) and HLA-A*11(29.92%) took the primary and secondary place of HLA-A alleles, while HLA-B*15(16.71%) and HLA-B*40(13.66%) took the primary and secondary place of HLA-B alleles. Besides, there were less typings of HLA-C and HLA-DRB1, and the distribution was average. The frequencies of HLA-A*0201, HLA-A*3001, HLA-C*0102, HLA-C*0302, HLA-C*0303were higher in NRP group than in RP group. After cART, the frequencies of HLA-B*3501, HLA-B*4601, HLA-DRB1*0901were higher in group of incompletely virology suppression than in group of completely virology suppression, the frequencies of HLA-A*0206, HLA-DRB1*030、HLA-DRB1*0403were lower in immunology responsive group, while HLA-DRB1*1501was on the opposite.[Conclusions] Our results showed that Chinese HIV/AIDS patients had highly polymorphism of HLA molecules. HIV/AIDS disease progression was affected by gender, age and the way of infection. Baseline viral load and the way of infection were independent influence factors of virology suppressive level after cART while patients’ age at the beginning of treatment was an independent influence factor of immune reconstitution. Maybe HLA polymorphism not only had an influence on HIV/AIDS disease progression but also impacted the response to cART, but the mechanism was unknown.

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