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      Association of ABO and RhD blood groups with the risk of HIV infection

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          Abstract

          Naturally occurring antibodies against ABO antigens present in human sera have been shown to neutralize ABO-expressing HIV in vitro. We investigated associations between ABO and RhD blood groups and HIV infection among blood donors from all blood collection centers in eight of South Africa’s nine provinces. Whole blood donations collected from first time donors between January 2012 and September 2016 were tested for HIV RNA by nucleic acid testing and HIV antibody using third generation serology assays. ABO and RhD blood types were determined using automated technology. Odds ratios for the association between HIV positivity and ABO and RhD phenotypes were calculated using multivariable logistic regression analysis. We analyzed 515,945 first time blood donors and the overall HIV prevalence was 1.12% (n = 5790). After multivariable adjustment, HIV infection was weakly associated with RhD positive phenotype (OR = 1.15, 95% CI 1.00–1.33) but not with ABO blood group. The observed association with RhD positive phenotype was marginal and likely due to residual confounding by racial group but could serve to generate hypotheses for further studies.

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          Blood Groups in Infection and Host Susceptibility.

          Blood group antigens represent polymorphic traits inherited among individuals and populations. At present, there are 34 recognized human blood groups and hundreds of individual blood group antigens and alleles. Differences in blood group antigen expression can increase or decrease host susceptibility to many infections. Blood groups can play a direct role in infection by serving as receptors and/or coreceptors for microorganisms, parasites, and viruses. In addition, many blood group antigens facilitate intracellular uptake, signal transduction, or adhesion through the organization of membrane microdomains. Several blood groups can modify the innate immune response to infection. Several distinct phenotypes associated with increased host resistance to malaria are overrepresented in populations living in areas where malaria is endemic, as a result of evolutionary pressures. Microorganisms can also stimulate antibodies against blood group antigens, including ABO, T, and Kell. Finally, there is a symbiotic relationship between blood group expression and maturation of the gastrointestinal microbiome.
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            The relationship between blood groups and disease.

            The relative contribution of founder effects and natural selection to the observed distribution of human blood groups has been debated since blood group frequencies were shown to differ between populations almost a century ago. Advances in our understanding of the migration patterns of early humans from Africa to populate the rest of the world obtained through the use of Y chromosome and mtDNA markers do much to inform this debate. There are clear examples of protection against infectious diseases from inheritance of polymorphisms in genes encoding and regulating the expression of ABH and Lewis antigens in bodily secretions particularly in respect of Helicobacter pylori, norovirus, and cholera infections. However, available evidence suggests surviving malaria is the most significant selective force affecting the expression of blood groups. Red cells lacking or having altered forms of blood group-active molecules are commonly found in regions of the world in which malaria is endemic, notably the Fy(a-b-) phenotype and the S-s- phenotype in Africa and the Ge- and SAO phenotypes in South East Asia. Founder effects provide a more convincing explanation for the distribution of the D- phenotype and the occurrence of hemolytic disease of the fetus and newborn in Europe and Central Asia.
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              Whole-genome sequencing for an enhanced understanding of genetic variation among South Africans

              The Southern African Human Genome Programme is a national initiative that aspires to unlock the unique genetic character of southern African populations for a better understanding of human genetic diversity. In this pilot study the Southern African Human Genome Programme characterizes the genomes of 24 individuals (8 Coloured and 16 black southeastern Bantu-speakers) using deep whole-genome sequencing. A total of ~16 million unique variants are identified. Despite the shallow time depth since divergence between the two main southeastern Bantu-speaking groups (Nguni and Sotho-Tswana), principal component analysis and structure analysis reveal significant (p < 10−6) differentiation, and FST analysis identifies regions with high divergence. The Coloured individuals show evidence of varying proportions of admixture with Khoesan, Bantu-speakers, Europeans, and populations from the Indian sub-continent. Whole-genome sequencing data reveal extensive genomic diversity, increasing our understanding of the complex and region-specific history of African populations and highlighting its potential impact on biomedical research and genetic susceptibility to disease.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: MethodologyRole: ValidationRole: VisualizationRole: Writing – original draft
                Role: SupervisionRole: Writing – review & editing
                Role: ResourcesRole: Writing – review & editing
                Role: Data curationRole: Writing – review & editing
                Role: InvestigationRole: Writing – review & editing
                Role: ConceptualizationRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLOS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                26 April 2023
                2023
                26 April 2023
                : 18
                : 4
                : e0284975
                Affiliations
                [1 ] South African National Blood Service, Johannesburg, South Africa
                [2 ] Vitalant Research Institute, San Francisco, California, United States of America
                [3 ] University of California San Francisco, San Francisco, California, United States of America
                United States Environmental Protection Agency, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0003-1561-9853
                Article
                PONE-D-22-29670
                10.1371/journal.pone.0284975
                10132593
                37099490
                d2e35e7c-74fd-4b05-9420-ead5ec83a934
                © 2023 Jacobs et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 27 October 2022
                : 12 April 2023
                Page count
                Figures: 1, Tables: 1, Pages: 8
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/100016958, Office of Research Infrastructure Programs, National Institutes of Health;
                Award ID: HHSN268201100009I
                Funded by: funder-id http://dx.doi.org/10.13039/100016958, Office of Research Infrastructure Programs, National Institutes of Health;
                Award ID: HHSN268201100002I
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/100016958, Office of Research Infrastructure Programs, National Institutes of Health;
                Award ID: HHSN2682011-00001I
                Award Recipient :
                Funded by: funder-id http://dx.doi.org/10.13039/100000061, Fogarty International Center;
                Award ID: D43-TW010345
                Award Recipient :
                This work was supported by research contracts from the National Heart, Lung and Blood Institute of the National Institutes of Health (NIH) for the Recipient Epidemiology and Donor Evaluation Study-III International program: HHSN268201100009I (to UCSF and the South African National Blood Service), HHSN268201100002I (to RTI International) and HHSN2682011-00001I (to Vitalant Research Institute); and NIH Fogarty International Center grant D43-TW010345 (to ELM). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
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                Custom metadata
                Because the analytic dataset contains sensitive information on HIV status and several demographic and geographic variables, it is conceivably possible to identify the HIV status of a participant of a particular sex, age, race and geographic location. Because of this potential risk to confidentiality, requests for minimal datasets will be reviewed by the SANBS Human Research Ethics Committee and made available consistent with regulatory and ethical considerations in force at the time of request (contact via https://sanbs.org.za/research).
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