Insights to HIV-1 coreceptor usage by estimating HLA adaptation with Bayesian generalized linear mixed models

The mechanisms triggering the human immunodeficiency virus type I (HIV-1) to switch the coreceptor usage from CCR5 to CXCR4 during the course of infection are not entirely understood. While low CD4+ T cell counts are associated with CXCR4 usage, a predominance of CXCR4 usage with still high CD4+ T cell counts remains puzzling. Here, we explore the hypothesis that viral adaptation to the human leukocyte antigen (HLA) complex, especially to the HLA class II alleles, contributes to the coreceptor switch. To this end, we sequence the viral gag and env protein with corresponding HLA class I and II alleles of a new cohort of 312 treatment-naive, subtype C, chronically-infected HIV-1 patients from South Africa. To estimate HLA adaptation, we develop a novel computational approach using Bayesian generalized linear mixed models (GLMMs). Our model allows to consider the entire HLA repertoire without restricting the model to pre-learned HLA-polymorphisms. In addition, we correct for phylogenetic relatedness of the viruses within the model itself to account for founder effects. Using our model, we observe that CXCR4-using variants are more adapted than CCR5-using variants (p-value = 1.34e-2). Additionally, adapted CCR5-using variants have a significantly lower predicted false positive rate (FPR) by the geno2pheno[coreceptor] tool compared to the non-adapted CCR5-using variants (p-value = 2.21e-2), where a low FPR is associated with CXCR4 usage. Consequently, estimating HLA adaptation can be an asset in predicting not only coreceptor usage, but also an approaching coreceptor switch in CCR5-using variants. We propose the usage of Bayesian GLMMs for modeling virus-host adaptation in general. Viral control via treatment is currently our only counter mechanism against HIV-1 with no practicable cure nor a vaccine at hand. In treatment-naive patients, host immune responses denote the only counter-mechanism. HLA adaptation and coreceptor usage of HIV-1 play a major role on the capability of the host immune responses to control the virus. The interplay between both factors, however, has remained unexplored so far. Assessing the degree of viral HLA adaptation is challenging due to the exceptional genetic diversity of both the HLA complex and HIV-1. Therefore, current approaches constrain the adaptation prediction to a set of p-value selected HLA-polymorphism candidates. The selection of these candidates, however, requires extensive external large-scale population-based experiments that are not always available for the population of interest, especially not for newly emerging viruses. In this work, we present a novel computational approach using Bayesian generalized linear mixed models (GLMMs) that enables not only to predict the adaptation to the complete HLA profile of a patient, but also to handle phylogenetic-dependencies of the variants within the model directly. Using this light-weight approach for modeling (any) virus-host adaptation, we show that HLA adaptation is associated with coreceptor usage.