HLA-B*44 Is Associated with a Lower Viral Set Point and Slow CD4 Decline in a Cohort of Chinese Homosexual Men Acutely Infected

HLA class I alleles have been shown to have differential impacts on the viral load and the outcome of HIV-1 disease progression. In this study, HLA class I types from residents of China with acute HIV-1 infection, diagnosed between 2006 and 2011, were identified and the association between expression of individual HLA alleles and the level of the set point viral load was analyzed. A lower level of set point viral load was found to be associated with the Bw4 homozygote on HLA-B alleles. B*44 and B*57 alleles have also been found to be associated with lower set point viral load. The set point viral load of B*44-positive individuals ho-mozygous for Bw4 was significantly lower than that of B*44-negative individuals homozygous for Bw4 (P 0.030). The CD4 count declined to<350 in fewer B*44-positive individuals than B*44-negative individuals (X2 7.295, P 0.026). B*44-positive individuals had a lower magnitude of p24 pool-specific T cell responses than B*44-negative individuals homozygous for Bw4, though this was not statistically significant. The p24 pool-specific T cell responses were also inversely correlated with lower viral load (rs0.88, P 0.033). Six peptides within p24 were recognized to induce the specific-T cell response in B*44-positive indi-viduals, and the peptide breadth of response was same as that in B*44-negative individuals homozygous for Bw4, but the median magnitude of specific-T cell responses to the recognized peptides in B*44-positive individuals was lower than that in B*44-nega-tive individuals homozygous for Bw4 (P 0.049). These findings imply that weak p24-specific CD8 T cell responses might play an important role in the control of HIV viremia in B*44 allele-positive individuals. Such studies might contribute to the develop-ment of future therapeutic strategies that take into account the genetic background of the patients