- Ramsuran, Veron;
- Naranbhai, Vivek;
- Horowitz, Amir;
- Qi, Ying;
- Martin, Maureen P;
- Yuki, Yuko;
- Gao, Xiaojiang;
- Walker-Sperling, Victoria;
- Del Prete, Gregory Q;
- Schneider, Douglas K;
- Lifson, Jeffrey D;
- Fellay, Jacques;
- Deeks, Steven G;
- Martin, Jeffrey N;
- Goedert, James J;
- Wolinsky, Steven M;
- Michael, Nelson L;
- Kirk, Gregory D;
- Buchbinder, Susan;
- Haas, David;
- Ndung’u, Thumbi;
- Goulder, Philip;
- Parham, Peter;
- Walker, Bruce D;
- Carlson, Jonathan M;
- Carrington, Mary
The highly polymorphic human leukocyte antigen (HLA) locus encodes cell surface proteins that are critical for immunity. HLA-A expression levels vary in an allele-dependent manner, diversifying allele-specific effects beyond peptide-binding preference. Analysis of 9763 HIV-infected individuals from 21 cohorts shows that higher HLA-A levels confer poorer control of HIV. Elevated HLA-A expression provides enhanced levels of an HLA-A-derived signal peptide that specifically binds and determines expression levels of HLA-E, the ligand for the inhibitory NKG2A natural killer (NK) cell receptor. HLA-B haplotypes that favor NKG2A-mediated NK cell licensing (i.e., education) exacerbate the deleterious effect of high HLA-A on HIV control, consistent with NKG2A-mediated inhibition impairing NK cell clearance of HIV-infected targets. Therapeutic blockade of HLA-E:NKG2A interaction may yield benefit in HIV disease.