Title : Associations between DRB1 alleles and HIV disease progression in people living with HIV/AIDS(PLWHA) receiving Antiretroviral Therapy (ART)
Abstract:
Introduction: Background: HIV infection leads to progressive immune decline and increased vulnerability to opportunistic infections, primarily driven by viral replication and the depletion of CD4+ T-cells. Host genetic factors, particularly variations within the HLA region, have been linked to immune recovery and disease progression. This study aims to investigate the associations between DRB1 alleles and HIV disease progression in patients undergoing antiretroviral therapy (ART), focusing on CD4 count dynamics, viral load trends, and susceptibility to opportunistic infections such as tuberculosis.
Materials and Methods: This study conducted clinical data and genetic analysis of 116 PLWHA patients aged 24-60 years (60 males and 56 females) who were receiving ART. Longitudinal data included CD4 counts and viral load measured at three distinct time points, along with DRB1 genotype information. Statistical tests were performed, including one-way ANOVA for continuous variables and chi-square tests for categorical data, to identify significant associations. Missing values were imputed using column means, and DRB1 loci groups with fewer than five patients were excluded from the analysis to ensure statistical robustness.
Results: The study identified significant associations (P < 0.05) between specific DRB1 alleles and markers of HIV disease progression in patients undergoing antiretroviral therapy (ART). Notably, the DRB1*11 allele emerged as a key factor, showing a strong correlation with both CD4 count dynamics and viral load trends. Patients carrying the DRB1*11 allele exhibited significantly higher CD4 counts over time, indicating improved immune recovery, as well as lower viral loads, which suggest better viral suppression.
The DRB1*17 allele also demonstrated trends indicating a protective effect, although this was less pronounced. In terms of opportunistic infections, the DRB1*13 and DRB1*03 alleles were significantly associated with the presence of tuberculosis, highlighting their potential role in susceptibility to this co-infection. These findings support the hypothesis that specific DRB1 loci influence HIV disease progression and align with previous studies emphasizing the role of HLA gene variations in immune regulation and disease outcomes.
Conclusions: These findings underscore the potential of DRB1 alleles Conclusions: These findings highlight the potential of DRB1 loci as genetic markers for disease progression and treatment outcomes in HIV patients receiving antiretroviral therapy (ART). The DRB1*11 allele is associated with better immune recovery and viral suppression, while DRB1*13, *17, and *03 alleles relate to CD4 recovery and tuberculosis susceptibility, respectively. The link between DRB1*13 and tuberculosis underscores the relationship between host genetics and opportunistic infections. Overall, these results support the role of HLA variations in HIV pathogenesis and suggest that DRB1 alleles could serve as valuable biomarkers for personalized disease management.
