APOL1 variant alleles associate with reduced risk for opportunistic infections in HIV infection

Abstract

Apolipoprotein L1 (APOL1), an innate immune factor against African trypanosoma brucei, inhibits HIV-1 in vitro. The impact of APOL1 G1-G2 variants on HIV-1-associated opportunistic infections (OIs) is unknown. Here, we report findings from a metaanalysis of four HIV/AIDS prospective cohorts (ALIVE, LSOCA, MACS, and WIHS) including 2066 African American participants. Using a global test combining all four cohorts, carriage of two APOL1 variant alleles is associated with a 50% reduction in odds of OI (combined OR 0.50, 95% CI 0.33-0.76). Subgroup analysis of OI etiological categories (viral, parasitic, fungal and Mycobacterial) suggests the possibility of specific protection from fungal infections (OR 0.54. 95% CI 0.32-0.93; P_{Bonferroni corrected} = 0.08). We observe an association of APOL1 variant alleles with host protection against OI in HIV-positive individuals. The study suggests a broader role of APOL1 variant alleles in innate immunity in vivo.

Fig. 1. Forest plot showing the odds ratios (OR) of opportunistic infection (OI) for the carriage of 2 versus 1 or 0 APOL1 variant alleles in the meta-analysis of four HIV/AIDS cohorts.

Data were pooled from the four studies using inverse variance (IV) (Table 3). The red block indicates the point estimate of OR, while the horizontal line depicts 95% CI of OR in each study. The area of the block indicates the weight assigned to that study in the meta-analysis.