HLA B*5701 is highly associated with restriction of virus replication in a subgroup of HIV-infected long term nonprogressors

Abstract

A unique cohort of HIV-1-infected long term nonprogressors (LTNP) with normal CD4+T cell counts and <50 copies/ml of plasma were prospectively recruited for study. HLA typing revealed a dramatic association between the HLA B*5701 class I allele and nonprogressive infection [85% (11 of 13) vs. 9.5% (19 of 200) in progressors;P< 0.001]. Antigen-specific CD8+T cells were enumerated by flow cytometric detection of intracellular IFN-γ in response to HIV antigens and HLA B*57-gag tetramer staining. No quantitative differences in the total HIV-specific CD8+T cell responses were observed between B*57+LTNP and five B*57+progressors (P= 0.4). Although similar frequencies of peptide specific CD8+T cells were also found, the gag-specific CD8+T cell response in the LTNP group was highly focused on peptides previously shown to be B*57-restricted. These findings indicate that, within this phenotypically and genotypically distinct cohort, a host immune factor is highly associated with restriction of virus replication and nonprogressive disease. They also strongly suggest a mechanism of virus specific immunity that directly operates through the B*5701 molecule. Further characterization of qualitative differences in the virus-specific responses that distinguish HLA B*57+LTNP from progressors may ultimately define mechanisms of effective immune mediated restriction of virus replication.