Genetic restriction of HIV-1 pathogenesis to AIDS by promoter alleles of IL10

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Abstract
IL10 is a powerful TH-2 cell cytokine produced by lymphoid cells that limits HIV-1 replicationin vivo, ostensibly by inhibiting macrophage/monocyte and T-cell lymphocyte replication and secretion of inflammatory cytokines (IL1, TNFα, IL6, IL8, and IL12). A genetic epidemiological scan of patients enrolled in AIDS cohorts for candidate gene-linked short tandem repeat polymorphisms revealed significant genotype associations for HIV-1 infection and progression to AIDS with markers adjacent to and tracking (by linkage disequilibrium) common single nucleotide polymorphic variants in theIL10promoter region. Individuals carrying theIL10-5′−592A(IL10-5′A) promoter allele possibly were at increased risk for HIV-1 infection, and once infected they progressed to AIDS more rapidly than homozygotes for the alternativeIL10-5′−592 C/C(IL10-+/+) genotype, particularly in the later stages of HIV-1 infection. An estimated 25–30% of long-term nonprogressors (who avoid clinical AIDS for 10 or more years after HIV-1 infection) can be attributed to theirIL10-+/+ promoter genotype. AlternativeIL10promoter alleles are functionally distinct in relative IL10 production, in retention of an avian erythroblastosis virus transcription factor recognition sequence and in binding to specific putative nuclear transcription factors, suggesting a potential mechanism wherebyIL10-5′Adown-regulation of inhibitory IL10 facilitates HIV-1 replicationin vivo, accelerating the onset of AIDS.