Association of HLA types A1-B8-DR3 and B27 with rapid and slow progression of HIV disease

We examined how HLA types A1-B8-DR3 and B27 were related to progression ofclinical disease and rate of loss of CD4 lymphocytes in the Edinburgh CityHospital cohort of HIV-positive patients, mainly injection drug users.Patients (n = 692) were prospectively followed from 1985 through March1994. Accurately estimated seroconversion times were determinedretrospectively for a subgroup of 313 (45%). Of 262 patients (39%) who werefully or partially HLA typed, 155 (50%) had known seroconversions. Of 34patients typed positive for A1-B8-DR3, 29 progressed to CDC stage IV, 22 toAIDS and 20 died. Twelve patients were typed positive for B27; six of theseprogressed to CDC stage IV, one to AIDS and none died. In a proportionalhazards analysis of the 313 patients with known seroconversions, A1-B8-DR3was significantly associated with covariate-adjusted relative risks of 3.7(95% CI 1.9- 7.2), 3.1 (1.6-6.0) and 1.9 (1.1-3.2) for progression fromseroconversion to death, AIDS and CDC stage IV, respectively. Events forB27 were too rare to include B27 in analyses to death and AIDS, but B27 wassignificantly associated with slower progression to CDC stage IV (0.3, CI0.1-0.9). Random effects growth curve models were used to estimateindividual rates of loss of square root CD4 count and loss of CD4percentage, for 603 and 617 patients, respectively. A1-B8-DR3 wasassociated with rapid loss of both markers (p = 0.02 and p = 0.01,respectively); B27 was associated with slow loss of both markers (p = 0.04and p < 0.005).