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HLA B*5701 status, disease progression, and response to antiretroviral therapy

The UK Collaborative HIV Cohort Study Steering Committee

doi: 10.1097/01.aids.0000432613.95455.71
Clinical Science: Concise Communication

Objective: In addition to hypersensitivity reactions to abacavir, HLA B*5701 has been associated with slow or nonprogression of HIV infection. We explored the effect of HLA B*5701 on CD4+ cell count and viral load in untreated patients and on responses to nonabacavir-containing combination antiretroviral therapy (cART) in a large UK-based cohort.

Design: Analysis of a cohort of HIV-infected adults.

Methods: In untreated patients, CD4+ cell count and viral load at study entry were compared in HLAB*5701-positive and HLAB*5701-negative individuals and linear regression tested for an interaction effect of viral load and HLA B*5701 on CD4+ cell count. In patients starting a nonabacavir cART regimen, Cox proportional hazards models compared virological responses to cART among HLA B*5701-negative, HLA B*5701-positive, and those not tested. Six-month and 12-month changes in CD4+ cell count were used as outcomes in linear regression to compare immunological response to cART in these groups.

Results: ART-naive HLA B*5701-positive individuals had higher CD4+ cell count (P <0.0001) and lower viral load (P <0.0001) at study entry than negatives; however, HLA B*5701 status was not found to effect the association between viral load and CD4+ cell count (interaction P value = 0.09). HLA B*5701-positive patients were more likely to achieve viral suppression than negative patients on a nonabacavir regimen [hazard ratio = 1.29, 95% confidence interval, CI (1.15–1.54)] and less likely to experience viral rebound [hazard ratio = 0.61, 95% CI (0.37–0.99)].

Conclusion: Better virological but not immunological responses to cART were seen in HLA B*5701-positive patients on nonabacavir regimens. This study provides further evidence of the potentially beneficial effect of HLA B*5701 on HIV progression.

Research Department of Infection & Population Health, UCL, London, UK.

Correspondence to Miss Sophie Jose, HIV Epidemiology & Biostatistics Group, Research Department of Infection & Population Health, UCL, Floor 1, Royal Free Campus, London NW3 2PF, UK. Tel: +44207 794 0500 ext. 36763; e-mail:

This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.

Received May 7, 2013

Accepted July 1, 2013

© 2013 Lippincott Williams & Wilkins, Inc.