Abstract Body

Background

Mitochondria are crucial for cellular energy metabolism and immune regulation, but their role in spontaneous HIV control remains unclear. We hypothesized that single nucleotide polymorphisms (SNPs) in mitochondrial-related genes influence HIV control.

Methods

SNP-set enrichment analysis was conducted to determine if SNPs in autosomal mitochondrial-related genes are enriched in HIV-control associated SNPs compared to the rest of the genome, using GWAS summary statistics from Europeans in the 2000HIV cohort (NCT03994835). This analysis included 67 HIV controllers and 1,176 non-controllers. Functionally relevant SNPs were prioritized using expression quantitative trait loci (eQTL) data. The effect of prioritized SNP genotypes on gene expression and total HIV reservoir DNA copies/million CD4+ T cells in PBMCs was tested using linear regression. Flow cytometry and single-cell expression data were used to explore immune activation and gene expression at single cell level. Co-expression network and pathway enrichment analyses were performed to explore relationships between prioritized genes and pathways.

Results

SNP-set enrichment analysis revealed significant enrichment in mitochondrial genes associated with HIV control (P<1e-5, Figure 1A). Prioritization with eQTLs identified six independent SNPs and four mitochondrial-related genes. Three independent SNPs near VARS2 (rs4713462, rs28436034, rs9266658) significantly associated with HIV control, higher VARS2 expression, and lower viral reservoirs (P<0.05, Figure 1B). VARS2 expression negatively correlated with total reservoir DNA (P<0.05, R2=0.01) and positively with CD4 counts (P<0.05, R2=0.14). Flow cytometry showed VARS2 expression positively associated with T cell activation (memory subsets) and negatively with granulocyte and monocyte activation. Single-cell expression data showed VARS2 highly expressed in T cells. Co-expression analysis revealed VARS2 co-expressed with genes enriched (P<0.01) in mitochondrial tRNA processing and suppression of pro-inflammatory pathways.

Conclusions

Our findings highlight the role of mitochondrial-related genetic variants affecting VARS2 expression, essential for mitochondrial protein synthesis, in HIV reservoir size and immune pathways in European HIV controllers. VARS2 expression linked to heightened T cell activation, reduced innate immune activation, and lower viral reservoirs. This suggests that higher VARS2 expression promotes effective viral control and a protective role in long-term HIV control.