- Apps, Richard;
- Qi, Ying;
- Carlson, Jonathan M;
- Chen, Haoyan;
- Gao, Xiaojiang;
- Thomas, Rasmi;
- Yuki, Yuko;
- Del Prete, Greg Q;
- Goulder, Philip;
- Brumme, Zabrina L;
- Brumme, Chanson J;
- John, Mina;
- Mallal, Simon;
- Nelson, George;
- Bosch, Ronald;
- Heckerman, David;
- Stein, Judy L;
- Soderberg, Kelly A;
- Moody, M Anthony;
- Denny, Thomas N;
- Zeng, Xue;
- Fang, Jingyuan;
- Moffett, Ashley;
- Lifson, Jeffrey D;
- Goedert, James J;
- Buchbinder, Susan;
- Kirk, Gregory D;
- Fellay, Jacques;
- McLaren, Paul;
- Deeks, Steven G;
- Pereyra, Florencia;
- Walker, Bruce;
- Michael, Nelson L;
- Weintrob, Amy;
- Wolinsky, Steven;
- Liao, Wilson;
- Carrington, Mary
A variant upstream of human leukocyte antigen C (HLA-C) shows the most significant genome-wide effect on HIV control in European Americans and is also associated with the level of HLA-C expression. We characterized the differential cell surface expression levels of all common HLA-C allotypes and tested directly for effects of HLA-C expression on outcomes of HIV infection in 5243 individuals. Increasing HLA-C expression was associated with protection against multiple outcomes independently of individual HLA allelic effects in both African and European Americans, regardless of their distinct HLA-C frequencies and linkage relationships with HLA-B and HLA-A. Higher HLA-C expression was correlated with increased likelihood of cytotoxic T lymphocyte responses and frequency of viral escape mutation. In contrast, high HLA-C expression had a deleterious effect in Crohn's disease, suggesting a broader influence of HLA expression levels in human disease.