Genetic predisposition to HIV-1 infection and acquired immune deficiency virus syndrome: a review of the literature examining associations with HLA [corrected].

Researchers have been studying the relationship between host HLA type and the immune response to HIV-1 since early in the AIDS epidemic. Although the literature is replete with suggestions of an association, the exact locus and nature is unclear. This article reviews the current HLA-HIV/AIDS literature, providing a complete summary of all significant associations reported in journal articles (N = 30) between 1982 and 1993. Consistent associations with alleles comprising the haplotype DQ2-DR3-B8-Cw7-A1 and AIDS progression support a genetic component in AIDS progression. DQ1-DR1-B35-Cw4-A11 and DR5 also show consistent associations with HIV/AIDS outcomes, although it is unclear whether they are measuring susceptibility to HIV-1 infection, AIDS progression, or both. The question of whether HLA influences susceptibility to HIV-1 infection remains unanswered, as well-designed studies addressing this topic are lacking. Similarly, further studies are needed to clarify if HLA type is associated with KS. Several issues that complicate across-study comparisons are discussed including heterogeneity of both HLA and AIDS, potential confounding by race or risk group, and other biases which may influence results. In addition, several proposed biologic mechanisms are explored.