Abstract
The expression of blood group antigens varies across human populations and geographical regions due to natural selection and the influence of environment factors and disease. The red cell membrane is host to numerous surface antigens which are able to influence susceptibility to disease, by acting as receptors for pathogens, or by influencing the immune response. Investigations have shown that Human Immunodeficiency Virus (HIV) can bind and gain entry into erythrocytes, and therefore it is hypothesized that blood groups could play a role in this process. The ABO blood group has been well studied. However, its role in HIV susceptibility remains controversial, while other blood group antigens, and the secretor status of individuals, have been implicated. The Duffy antigen is a chemokine receptor that is important in the inflammatory response. Those who lack this antigen, and type as Duffy null, could therefore be susceptible to HIV infection, especially if associated with neutropenia. Other antigens including those in the Rh, Lutheran and OK blood group systems have all been shown to interact with HIV. More recently, experiments show that cells which overexpress the Pk antigen appear to be protected against infection. These reports all demonstrate that red cell antigens interact and influence HIV infection. However, as the red cell membrane is complex and the pathogenesis of HIV multi-factorial, the role of blood group antigens cannot be studied in isolation.
Highlights
It has been estimated that 37.9 million people carry Human Immunodeficiency Virus (HIV) and that Sub-Saharan Africa has the highest burden of infection [1]
Others have gone on to reveal that in the absence of antibodies and complement, cell-free HIV was still capable of binding to red cells and, it was concluded that red cells, like dendritic cells, could act as a viral reservoir prior to the invasion of CD4+ cells [4]
The main objective of this short review was to provide an update on the association of blood group antigens and the pathogenesis of HIV infection
Summary
It has been estimated that 37.9 million people carry Human Immunodeficiency Virus (HIV) and that Sub-Saharan Africa has the highest burden of infection [1]. CD71+ erythrocytes in HIV+ individuals are host to both intracellular and surface HIV particles, which significantly increases the movement, infectivity and replication of the virus [5] These reports have all raised questions around the exact mechanism of HIV attachment and whether blood group antigens influence susceptibility. The presence or absence of red cell antigens has been implicated in the susceptibility and pathogenesis of bacterial, viral and parasitic infections These include Vibrio cholera [14], Escherichia coli [15], Helicobacter pylori [16], Norovirus [17], Rotavirus [18], and Human Immunodeficiency. In Sub-Saharan Africa, where the majority of the population phenotype as Duffy null (Fy(a-b-)) and do not express this antigen, many individuals are protected against both Plasmodium vivax and Plasmodium knowlesi [20] These reports all provide evidence that blood group antigens could influence the pathogenesis of infectious disease including HIV. The main objective of this review was to re-examine the current knowledge on this subject in an attempt to provide further clarity on the association between HIV and red cell antigens
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