Rising HIV-1 viral load set point at a population level coincides with a fading impact of host genetic factors on HIV-1 control

Objective: Heterozygosity for a 32 base pair deletion in the CCR5 gene (CCR5wt/Delta 32) and the minor alleles of a single-nucleotide polymorphism in the HCP5 gene (rs2395029) and in the HLA-C gene region (-35HLA-C; rs9264942) has been associated with a lower viral load set point. Recent studies have shown that over calendar time, viral load set point has significantly increased at a population level. Here we studied whether this increase coincides with a fading impact of above-mentioned host genetic markers on HIV-1 control. Methods: We compared the association between viral load set point and HCP5 rs2395029, -35HLA-C rs9264942, and the CCR5wt/Delta 32 genotype in HIV-1-infected individuals in the Netherlands who had seroconverted between 1982 and 2002 (pre2003 seroconverters, n = 459) or between 2003 and 2009 (post-2003 seroconverters, n 231). Results: Viral load set point in post-2003 seroconverters was significantly higher than in pre-2003 seroconverters (P = 4.5 x 10(-5)). The minor alleles for HCP5 rs2395029, -35HLA-C rs9264942 and CCR5wt/Delta 32 had a similar prevalence in both groups and were all individually associated with a significantly lower viral load set point in pre-2003 seroconverters. In post-2003 seroconverters, this association was no longer observed for HCP5 rs2395029 and CCR5wt/Delta 32. The association between viral load set point and HCP5 rs2395029 had significantly changed over time, whereas the change in impact of the CCR5wt/Delta 32 genotype over calendar time was not independent from the other markers under study. Conclusion: The increased viral load set point at a population level coincides with a lost impact of certain host genetic factors on HIV-1 control. (C) 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins