Mitochondrial DNA variation and HIV-associated sensory neuropathy in CHARTER

Abstract

HIV-associated sensory neuropathy remains an important complication of combination antiretroviral therapy and HIV infection. Mitochondrial DNA haplogroups and single nucleotide polymorphisms (SNPs) have previously been associated with symptomatic neuropathy in clinical trial participants. We examined associations between mitochondrial DNA variation and HIV-associated sensory neuropathy in CNS HIV Antiretroviral Therapy Effects Research (CHARTER). CHARTER is a USA-based longitudinal observational study of HIV-infected adults who underwent a structured interview and standardized examination. HIV-associated sensory neuropathy was determined by trained examiners as ≥1 sign (diminished vibratory and sharp-dull discrimination or ankle reflexes) bilaterally. Mitochondrial DNA sequencing was performed and haplogroups were assigned by published algorithms. Multivariable logistic regression of associations between mitochondrial DNA SNPs, haplogroups, and HIV-associated sensory neuropathy were performed. In analyses of associations of each mitochondrial DNA SNP with HIV-associated sensory neuropathy, the two most significant SNPs were at positions A12810G [odds ratio (95 % confidence interval) = 0.27 (0.11-0.65); p = 0.004] and T489C [odds ratio (95 % confidence interval) = 0.41 (0.21-0.80); p = 0.009]. These synonymous changes are known to define African haplogroup L1c and European haplogroup J, respectively. Both haplogroups were associated with decreased prevalence of HIV-associated sensory neuropathy compared with all other haplogroups [odds ratio (95 % confidence interval) = 0.29 (0.12-0.71); p = 0.007 and odds ratio (95 % confidence interval) = 0.42 (0.18-1.0); p = 0.05, respectively]. In conclusion, in this cohort of mostly combination antiretroviral therapy-treated subjects, two common mitochondrial DNA SNPs and their corresponding haplogroups were associated with a markedly decreased prevalence of HIV-associated sensory neuropathy.

Fig. 1

Results for association of mitochondrial SNPs with HIV-SN using multivariable logistic regression analyses adjusting for age, D-drug therapy, nadir CD4 count, and population substructure. Each variant is denoted by the base pair position and the base pair change. The haplogroup(s) with which these variants are associated are shown in parentheses. The top row displays the –log₁₀(p-value) with a triangle that denotes the direction of effect. The second row displays the log odds and corresponding 95% confidence interval. The third row displays the minor allele frequency (MAF) of each variant.

Fig. 2

Results for association of mitochondrial haplogroups with HIV-SN (solid line) and neuropathic pain (dashed line) using multivariable logistic regression analyses adjusting for age, D-drug therapy, nadir CD4 count, and population substructure.