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Published online 17 January 2006. doi:10.1084/jem.20051970
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© The Rockefeller University Press, 0022-1007
The Journal of Experimental Medicine

ARTICLE

 CCR5 deficiency increases risk of symptomatic West Nile virus infection

William G. Glass1, David H. McDermott1, Jean K. Lim1, Sudkamon Lekhong2, Shuk Fong Yu2, William A. Frank3, John Pape4, Ronald C. Cheshier2, and Philip M. Murphy1

1 Laboratory of Molecular Immunology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892
2 Bureau of State Laboratory Services and 3 Bureau of Epidemiology and Disease Control Services, Arizona Department of Health Services, Phoenix, AZ 85007
4 Colorado Department of Public Health and Environment, Denver, CO 80246

CORRESPONDENCE Philip M. Murphy: pmm{at}nih.gov

West Nile virus (WNV) is a reemerging pathogen that causes fatal encephalitis in several species, including mouse and human. Recently, we showed that the chemokine receptor CCR5 is critical for survival of mice infected with WNV, acting at the level of leukocyte trafficking to the brain. To test whether this receptor is also protective in man, we determined the frequency of CCR5{Delta}32, a defective CCR5 allele found predominantly in Caucasians, in two independent cohorts of patients, one from Arizona and the other from Colorado, who had laboratory-confirmed, symptomatic WNV infection. The distribution of CCR5{Delta}32 in a control population of healthy United States Caucasian random blood donors was in Hardy-Weinberg equilibrium and CCR5{Delta}32 homozygotes represented 1.0% of the total group (n = 1,318). In contrast, CCR5{Delta}32 homozygotes represented 4.2% of Caucasians in the Arizona cohort (odds ratios [OR] = 4.4 [95% confidence interval [CI], 1.6–11.8], P = 0.0013) and 8.3% of Caucasians in the Colorado cohort (OR = 9.1 [95% CI, 3.4–24.8], P < 0.0001). CCR5{Delta}32 homozygosity was significantly associated with fatal outcome in the Arizona cohort (OR = 13.2 [95% CI, 1.9–89.9], P = 0.03). We conclude that CCR5 mediates resistance to symptomatic WNV infection. Because CCR5 is also the major HIV coreceptor, these findings have important implications for the safety of CCR5-blocking agents under development for HIV/AIDS.


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