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Gene variants accelerate progression to AIDS
By Birgit Hofmann-Reinert

Researchers have identified gene variants in HIV-infected individuals that are associated with an increased risk for rapid progression to AIDS. While the AIDS virus is rapidly lethal in some people, the disease may take decades to develop in others who are infected.

Though it has been known for some time that HLA genes of the B*35 type are associated with AIDS progression, Mary Carrington, of the National Cancer Institute, in Frederick, Maryland, and colleagues have now discovered that a subtype termed 'Px' appears to acGNNte the onset of AIDS.

In a study of 850 HIV-positive patients, Carrington's team revealed that it took some individuals with the HLA-B*35-Px subtype a much shorter time to develop AIDS compared to those with other versions of the gene. The most common subtype, HLA-B*3501, did not have any increase in the rate of progression. The findings are published in the current issue of The New England Journal of Medicine.

HLA (human leukocyte antigens) are proteins that are located on the surface of white blood cells and other tissues in the body. They play a key role in the immune system's response towards viruses and other foreign invaders.

The researchers conclude that "in patients with HIV-1 infection, a single amino acid change in HLA molecules has a substantial effect on the rate of progression to AIDS."

Knowing about these genetic differences could help doctors treat HIV patients individually and take a more aggressive stance at an early stage towards those with the Px gene variants.

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Gao, X. et al. Effect of a single amino acid change in MHC class I molecules on the rate of progression to AIDS. N Engl J Med 344, 1668-1675 (May 31, 2001).

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