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Effect of Genetic Variation on HIV Transmission and Progression to AIDS

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AIDS in Africa

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Conclusion

The identification of genetic factors that regulate HIV-1 infection and AIDS kinetics has clarified our view of viral pathogenesis by illuminating the importance of host-virus interactions at virtually every stage of infection. Genetic studies often point to unexpected roles for host factors, providing insights into immune regulation of HIV-1 replication and possible selective forces that may influence HIV-1 quasispecies evolution. Host genetic factors have been shown to affect susceptibility to infection, the rate of CD4 + T-cell depletion, and the rate of progression to AIDS. Thus, it is important to consider the genetic background of the host when assessing the efficacy of antiretroviral agents and vaccines in clinical trials.

Unfortunately, as a consequence of inadequate funding, political barriers, and lack of resolve for confronting diseases in developing nations, there are far too few natural history cohort studies conducted in Africa. Many of the ones that are available have been established late in the epidemic, thus limiting their prospective longitudinal component. Human populations are evolving under varying selective pressures including infectious agents. Genetic variants that have a selective advantage in one situation sometimes have a selective disadvantage in others. Over time, selective pressures and genetic drift cause allele frequencies and haplotype structures to differ among populations. A definition of genetic factors influencing HIV-1 infection, pathogenesis, and rate of progression in individuals in Africa and Asia is essential to understanding geographic differences in HIV-1 epidemic dynamics and the interaction between host genetic factors, specific viral subtypes, and other environmental correlates of this disease.

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Authors and Affiliations

  1. Intramural Research Support Program, Science Applications International Corporation Frederick, National Cancer Institute, Frederick, MD, USA

    Cheryl A. Winkler

  2. Laboratory of Genomic Diversity, National Cancer Institute, Frederick, MD, USA

    Stephen J. O’Brien

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  1. Cheryl A. Winkler
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Editors and Affiliations

  1. Harvard AIDS Institute Mary Woodard Lasker Professor of Health Sciences Harvard University, Boston, Massachusetts, USA

    Max Essex DVM, PhD (Chairman) & Richard G. Marlink MD (Senior Research and Executive Director) (Chairman) &  (Senior Research and Executive Director)

  2. Laboratory of Bacteriology and Virology CHU Le Dantec, Université Cheikh Anta Diop, Dakar, Senegal

    Souleymane Mboup PharmD, PhD (Professor of Microbiology) (Professor of Microbiology)

  3. Department of Immunology and Infectious Diseases and the Harvard AIDS Institute, Harvard School of Public Health, Boston, Massachusetts, USA

    Phyllis J. Kanki DVM, DSc (Professor of Immunology and Infectious Diseases) & Molly Holme (Professor of Immunology and Infectious Diseases) & 

  4. Department of Nursing Education University of Botswana, Gaborone, Botswana

    Sheila D. Tlou PhD (Associate Professor) (Associate Professor)

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© 2002 Kluwer Academic Publishers

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Winkler, C.A., O’Brien, S.J. (2002). Effect of Genetic Variation on HIV Transmission and Progression to AIDS. In: Essex, M., Mboup, S., Kanki, P.J., Marlink, R.G., Tlou, S.D., Holme, M. (eds) AIDS in Africa. Springer, Boston, MA. https://doi.org/10.1007/0-306-47817-X_4

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  • DOI: https://doi.org/10.1007/0-306-47817-X_4

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