Effect of HLA/KIR genotypes on HIV disease progression in perinatally infected children from sub-Saharan Africa
The role of Human Leucocyte Antigen (HLA) and Killer-Cell Immunoglobulin-Like Receptor (KIR) molecules in adult HIV disease progression has been defined in many studies. Mechanisms proposed include the selection of viral escape mutants that reduce viral replicative capacity and increased CD8+ T-cell cytotoxic capacity. However, the factors contributing to variable disease progression in paediatric HIV infection are less well understood and remain contradictory. Disease progression in children has been associated with both viral and host genetic characteristics, suggesting the mediation of multiple immunological mechanisms in controlling HIV-1 viral replication. Functional characteristics of HIV-1-specific T cell responses are providing more insight to distinguish children with rapid and slow disease progression. This review discusses various reports on the role of HLA and KIR and other underlying factors in paediatric HIV-1 disease progression particularly in African populations where the disease remains endemic.