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Differential course of HIV-1 infection and apolipoprotein E polymorphism

  • Research Article
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Central European Journal of Medicine

Abstract

We studied the course of infection with human immunodeficiency virus type 1 (HIV-1) in relation to apolipoprotein E (APOE) polymorphism found for 209 Italians treated at Infectious Disease Clinics in Rome and Modena. Clinically, patients were classified into four groups according to the yearly rate of decline in CD4+ cell count (LTNP: long-term non-progression; SLOW, ’NORMAL’ or RAPID). Patients at both extremes of the clinical spectrum, i.e. those who rapidly progressed to AIDS and those with stable high CD4 cell counts, had few APOE ɛ4 and ɛ2 alleles (P = 0.04). Detailed clinical information was then used to construct four model-based clinical profiles using grade-of-membership analysis (GoM), predictive of APOE genotypic frequencies: 1. The clinical profile associated with good long-term prognosis lacked ɛ2 (P=0.01); 2. Disease progression to AIDS was associated with ɛ4 and ɛ2, most evident for zidovudine-lamivudine regimens without a protease inhibitor (P = 0.03); and, 3. AIDS patients had low ɛ4 and ɛ2 frequencies, consistent with a high mortality rate among ɛ4+ and ɛ2+ AIDS patients. These findings suggest allele-specific immunomodulatory effects involving inherited APOE isoform important enough to alter the clinical course of HIV infection and, possibly, drug efficacy. They imply a connection between lipid metabolism and immunity potentially relevant to common disorders.

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Authors and Affiliations

  1. Center for Demographic Studies, Duke University, 2117 Campus Drive, Durham, NC, 27708-0408, USA

    Elizabeth H. Corder

  2. Laboratorio Analisi e Diagnostica Molecolare I.N.R.C.A.-IRCCS, 60100, Ancona, Italy

    Luciano Galeazzi, Roberta Galeazzi & Sergio Giunta

  3. Direzione Scientifica I.N.R.C.A.-IRCCS, 60100, Ancona, Italy

    Claudio Franceschi

  4. Dept. of Biomedical Sciences, University of Modena and Reggio Emilia, 41100, Modena, Italy

    Andrea Cossarizza & Marcello Pinti

  5. Infectious Diseases Clinics, Azienda Policlinico, 41100, Modena, Italy

    Cristina Mussini & Vanni Borghi

  6. Dept.of Clinical Medicine, University “La Sapienza”, Rome, Italy

    Elena Pinter, Rita De Cristofaro & Fernando Aiuti

  7. Dept.of Medicine and Sciences of Aging, University “G. d’Annunzio” Chieti, Italy

    Roberto Paganelli

  8. Diatech Laboratories, Jesi, Italy

    Marino Perini

Authors
  1. Elizabeth H. Corder
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  2. Luciano Galeazzi
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  3. Claudio Franceschi
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  4. Andrea Cossarizza
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  7. Cristina Mussini
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  8. Vanni Borghi
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  9. Elena Pinter
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Correspondence to Elizabeth H. Corder.

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Corder, E.H., Galeazzi, L., Franceschi, C. et al. Differential course of HIV-1 infection and apolipoprotein E polymorphism. cent.eur.j.med 2, 404–416 (2007). https://doi.org/10.2478/s11536-007-0039-x

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  • DOI: https://doi.org/10.2478/s11536-007-0039-x

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