Association of HLA-A alleles with periodontitis in people living with HIV: A case control study.

Background: Periodontal disease (PD) is a common chronic inflammatory condition that progresses severely in people living with HIV (PLWH). Although human leukocyte antigen (HLA) class I molecules, including HLA-A alleles, are key to immune function, their role in PD susceptibility among PLWH is poorly understood. Objective: To identify the most frequent HLA-A alleles associated with PD in PLWH and determine those independently linked to PD status. Methods: A case-control genetic association study was conducted using buffy coat samples from 156 HIV-positive individuals enrolled at the MJAP-ISS Clinic. DNA was extracted, amplified via PCR, and sequenced using the Oxford Nanopore MinION platform. Due to sequencing throughput limitations, only 64 samples yielded usable sequence data. Allele frequencies were compared between PD cases and periodontally healthy controls. Statistical analyses included logistic regression, and ROC curve analysis. Results: Thirteen HLA-A alleles were identified. HLA-A11 was the most common allele among PD cases (48.4%) compared to controls (7.8%). A11 showed a significant association with PD (adjusted odds ratio [AOR] = 12.8; 95% CI: 3.36-61.6; p < 0.001). A sex-stratified analysis showed that the association was significant among females (AOR = 14.3), but not in males. Other alleles, such as A02 and A03 were not significantly associated. The model combining A11 and sex achieved the best performance (AUC = 0.867). Conclusion: HLA-A11 is significantly associated with PD in PLWH, especially among females, suggesting a gene-sex interaction. Further studies are needed to explore the immunological basis and validate findings across diverse populations.Clinical trial Number: Not applicable.