Browsing by Author "Haas, David W."

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    A high-resolution HLA reference panel capturing global population diversity enables multi-ancestry fine-mapping in HIV host response
    (Springer Nature, 2021) Luo, Yang; Kanai, Masahiro; Choi, Wanson; Li, Xinyi; Sakaue, Saori; Yamamoto, Kenichi; Ogawa, Kotaro; Gutierrez-Arcelus, Maria; Gregersen, Peter K.; Stuart, Philip E.; Elder, James T.; Forer, Lukas; Schönherr, Sebastian; Fuchsberger, Christian; Smith, Albert V.; Fellay, Jacques; Carrington, Mary; Haas, David W.; Guo, Xiuqing; Palmer, Nicholette D.; Chen, Yii-Der Ida; Rotter, Jerome I.; Taylor, Kent D.; Rich, Stephen S.; Correa, Adolfo; Wilson, James G.; Kathiresan, Sekar; Cho, Michael H.; Metspalu, Andres; Esko, Tonu; Okada, Yukinori; Han, Buhm; NHLBI Trans-Omics for Precision Medicine (TOPMed) Consortium; McLaren, Paul J.; Raychaudhuri, Soumya; Obstetrics and Gynecology, School of Medicine
    Fine-mapping to plausible causal variation may be more effective in multi-ancestry cohorts, particularly in the MHC, which has population-specific structure. To enable such studies, we constructed a large (n = 21,546) HLA reference panel spanning five global populations based on whole-genome sequences. Despite population-specific long-range haplotypes, we demonstrated accurate imputation at G-group resolution (94.2%, 93.7%, 97.8% and 93.7% in admixed African (AA), East Asian (EAS), European (EUR) and Latino (LAT) populations). Applying HLA imputation to genome-wide association study data for HIV-1 viral load in three populations (EUR, AA and LAT), we obviated effects of previously reported associations from population-specific HIV studies and discovered a novel association at position 156 in HLA-B. We pinpointed the MHC association to three amino acid positions (97, 67 and 156) marking three consecutive pockets (C, B and D) within the HLA-B peptide-binding groove, explaining 12.9% of trait variance.
  • Thumbnail Image
    Item
    Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2B6 and Efavirenz-Containing Antiretroviral Therapy
    (Wiley, 2019-04-21) Desta, Zeruesenay; Gammal, Roseann S.; Gong, Li; Whirl-Carrillo, Michelle; Gaur, Aditya H.; Sukasem, Chonlaphat; Hockings, Jennifer; Myers, Alan; Swart, Marelize; Tyndale, Rachel F.; Masimirembwa, Collen; Iwuchukwu, Otito F.; Chirwa, Sanika; Lennox, Jeffrey; Gaedigk, Andrea; Klein, Teri E.; Haas, David W.; Medicine, School of Medicine
    The human immunodeficiency virus (HIV) type-1 non-nucleoside reverse transcriptase inhibitor, efavirenz, is widely used to treat HIV-1 infection. Efavirenz is predominantly metabolized into inactive metabolites by CYP2B6, and patients with certain CYP2B6 genetic variants may be at increased risk for adverse effects, particularly central nervous system toxicity and treatment discontinuation. We summarize the evidence from the literature and provide therapeutic recommendations for efavirenz prescribing based on CYP2B6 genotypes.
  • Thumbnail Image
    Item
    Efavirenz Pharmacogenetics and Weight Gain Following Switch to Integrase Inhibitor-Containing Regimens
    (Oxford University Press, 2021) Leonard, Michael A.; Cindi, Zinhle; Bradford, Yuki; Bourgi, Kassem; Koethe, John; Turner, Megan; Norwood, Jamison; Woodward, Beverly; Erdem, Husamettin; Basham, Rebecca; Baker, Paxton; Rebeiro, Peter F.; Sterling, Timothy R.; Hulgan, Todd; Daar, Eric S.; Gulick, Roy; Riddler, Sharon A.; Sinxadi, Phumla; Ritchie, Marylyn D.; Haas, David W.; Medicine, School of Medicine
    Background: Unwanted weight gain affects some people living with human immunodeficiency virus (HIV) who are prescribed integrase strand transfer inhibitors (INSTIs). Mechanisms and risk factors are incompletely understood. Methods: We utilized 2 cohorts to study pharmacogenetics of weight gain following switch from efavirenz- to INSTI-based regimens. In an observational cohort, we studied weight gain at 48 weeks following switch from efavirenz- to INSTI-based regimens among patients who had been virologically suppressed for at least 2 years at a clinic in the United States. Associations were characterized with CYP2B6 and UGT1A1 genotypes that affect efavirenz and INSTI metabolism, respectively. In a clinical trials cohort, we studied weight gain at 48 weeks among treatment-naive participants who were randomized to receive efavirenz-containing regimens in AIDS Clinical Trials Group studies A5095, A5142, and A5202 and did not receive INSTIs. Results: In the observational cohort (n = 61), CYP2B6 slow metabolizers had greater weight gain after switch (P = .01). This was seen following switch to elvitegravir or raltegravir, but not dolutegravir. UGT1A1 genotype was not associated with weight gain. In the clinical trials cohort (n = 462), CYP2B6 slow metabolizers had lesser weight gain at week 48 among participants receiving efavirenz with tenofovir disoproxil fumarate (P = .001), but not those receiving efavirenz with abacavir (P = .65). Findings were consistent when stratified by race/ethnicity and by sex. Conclusions: Among patients who switched from efavirenz- to INSTI-based therapy, CYP2B6 genotype was associated with weight gain, possibly reflecting withdrawal of the inhibitory effect of higher efavirenz concentrations on weight gain. The difference by concomitant nucleoside analogue is unexplained.
  • Thumbnail Image
    Item
    GCH1 haplotypes and cardiovascular risk in HIV
    (Wolters Kluwer, 2019-05) Slaven, James E.; Haas, David W.; Liu, Ziyue; Stein, James H.; Brown, Todd T.; Gupta, Samir K.; Biostatistics, School of Public Health
    Heightened systemic inflammation contributes to cardiovascular (CVD) events in people living with HIV (PLWH), though not all PLWH develop CVD, thus suggesting a genetic modifying role. We examined GCH1 polymorphisms, which have been associated with reduced endothelial function in European populations with CVD and increased inflammation, in a racially diverse cohort of U.S. PLWH initiating antiretroviral therapy (ART). GCH1 polymorphisms differed by race and were not associated flow-mediated dilation or carotid intima media thickness before or after 48 weeks of ART.