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In the past few years, several genomewide association studies (GWASs) have been conducted to identify host genetic variants involved in control of human immunodeficiency virus type 1 (HIV-1) load and in progression to AIDS [1–10]. Overall, these GWASs emphasized the major role of the HLA chromosome 6 region, particularly the HCP5/HLA-B*57 rs2395029 signal [1–3, 5, 8], and the CXCR6 gene region [7]. These GWASs focused on viral load and disease progression, but genetic correlates of the HIV-1 acquisition phenotype have met limited success: 2 recent GWASs conducted in Malawi reported no significant determinants of HIV infection [11, 12]. Looking for new host factors correlated to HIV susceptibility is critical because the only validated association to date is the 32 base-pair deletion in the CCR5 gene: only 1%–2% of Europeans are homozygous for this mutation and exhibit a near-complete protection against infection by HIV-1 R5 strains [13, 14]. To identify additional genetic factors that might contribute to HIV-1 acquisition, we performed a meta-analysis using GWAS genotypic data from 2 European AIDS progression cohorts, comparing each group of HIV-1–infected patients with uninfected controls of the same ancestry [8, 15]. Next, we replicated the association for the single-nucleotide polymorphism (SNP) showing the smallest P value in the European meta-analysis on 2 independent US cohorts of European ancestry.

Background. Host genetic variation influences human immunodeficiency virus (HIV) infection and progression to AIDS. Here we used clinically well-characterized subjects from 5 pretreatment HIV/AIDS cohorts for a genome-wide association study to identify gene associations with rate of AIDS progression. Methods. European American HIV seroconverters (n = 755) were interrogated for single-nucleotide polymorphisms (SNPs) (n = 700,022) associated with progression to AIDS 1987 (Cox proportional hazards regression analysis, co-dominant model). Results. Association with slower progression was observed for SNPs in the gene PARD3B. One of these, rs11884476, reached genome-wide significance (relative hazard = 0.3; P =3. 370 × 10−9) after statistical correction for 700,022 SNPs and contributes 4.52% of the overall variance in AIDS progression in this study. Nine of the top-ranked SNPs define a PARD3B haplotype that also displays significant association with progression to AIDS (hazard ratio, 0.3; P = 3.220 × 10−8). One of these SNPs, rs10185378, is a predicted exonic splicing enhancer; significant alteration in the expression profile of PARD3B splicing transcripts was observed in B cell lines with alternate rs10185378 genotypes. This SNP was typed in European cohorts of rapid progressors and was found to be protective for AIDS 1993 definition (odds ratio, 0.43, P = .025). Conclusions. These observations suggest a potential unsuspected pathway of host genetic influence on the dynamics of AIDS progression.

a Background. The compilation of previous genomewide association studies of AIDS shows a major polymor- phism in the HCP5 gene associated with both control of the viral load and long-term nonprogression (LTNP) to AIDS. Methods. To look for genetic variants that affect LTNP without necessary control of the viral load, we reanalyzed the genomewide data of the unique LTNP Genomics of Resistance to Immunodeficiency Virus (GRIV) cohort by excluding "elite controller" patients, who were controlling the viral load at very low levels (!100 copies/mL). Results. The rs2234358 polymorphism in the CXCR6 gene was the strongest signal ( ; odds ratio, 7 P p 2.5 10 1.85) obtained for the genomewide association study comparing the 186 GRIV LTNPs who were not elite controllers with 697 uninfected control subjects. This association was replicated in 3 additional independent European studies, reaching genomewide significance of . This association with LTNP is independent of the 10 P p 9.7 10 combined CCR2-CCR5 locus and the HCP5 polymorphisms. Conclusions. The statistical significance, the replication, and the magnitude of the association demonstrate that CXCR6 is likely involved in the molecular etiology of AIDS and, in particular, in LTNP, emphasizing the power of extreme-phenotype cohorts. CXCR6 is a chemokine receptor that is known as a minor coreceptor in human immunodeficiency virus type 1 infection but could participate in disease progression through its role as a mediator of inflammation.