HLA and HIV-1:: Heterozygote advantage and B*35-Cw*04 disadvantage

A selective advantage against infectious disease associated with increased heterozygosity at the human major histocompatibility complex [human Leukocyte antigen (HLA) class I and class II] is believed to play a major role in maintaining the extraordinary allelic diversity of these genes. Maximum HLA heterozygosity of class I loci (A, B, and C) delayed acquired immunodeficiency syndrome (AIDS) onset among patients infected with human immunodeficiency virus-type 1 (HIV-1), whereas individuals who were homozygous for one or more Loci progressed rapidly to AIDS and death. The HLA class I alleles B*35 and Cw*04 were consistently associated with rapid development of: AIDS-defining conditions in Caucasians. The extended survival of 28 to 40 percent of HIV1-infected Caucasian patients who avoided AIDS for ten or more years can be attributed to their being Fully heterozygous at HLA class I Loci, to their Lacking the AIDS-associated alleles B*35 and Cw*04, or to both.