PRESENCE OF THE VARIANT MANNOSE-BINDING LECTIN ALLELES ASSOCIATED WITH SLOWER PROGRESSION TO AIDS

Objective: To examine the association between mannose-binding lectin ( MBL) polymorphism and progression to AIDS and death in HIV-1 infection . Design and methods: In 131 HIV-1-infected homosexual seroconverters, survival analyses were performed to determine both the association be tween MBL genotype and time from HIV-1 seroconversion to AIDS and deat h, and time from AIDS to death. Results: Of the 131 seroconverters, of whom 61 developed AIDS, 76 were typed as homozygous wild-type and 55 as carriers of variant alleles (52 heterozygous and three homozygous v ariant alleles). A Survival analyses suggested that HIV-1-infected men with the variant alleles progressed somewhat stower to AIDS [relative hazard (RH), 0.62; 95% confidence interval (CI), 0.36-1.10] and death (RH, 0.73; 95% CI, 0.42-1.25). Interestingly, CD4+ T-cell count deter mined at the moment of AIDS was found to be significantly lower among persons with the mutation (97 x 10(6)/l versus 204 x 10(6)/l; P = 0.03 ). Furthermore, when AIDS-free times before the diagnosis of an opport unistic infection were compared with those preceding a diagnosis of Ka posi's sarcoma, Kaposi's sarcoma diagnosis was more postponed than tha t of an opportunistic infection (RH, 0.21; 95% CI, 0.05-0.95; versus R H, 0.67; 95% CI, 0.35-1.27). Conclusion: Indications for a weak pre-AI DS protective effect of variant MBL alleles were demonstrated. (C) 199 8 Lippincott Williams & Wilkins.