Faster Progression to AIDS and AIDS-Related Death Among Seroincident Individuals Infected With Recombinant HIV-1 A3/CRF02_AG Compared With Sub-subtype A3

• Published in: The Journal of infectious diseases 2014-03, Vol.209 (5), p.721-728
• Main Authors: Palm, Angelica A., Esbjörnsson, Joakim, Månsson, Fredrik, Kvist, Anders, Isberg, Per-Erik, Biague, Antonio, da Silva, Zacarias José, Jansson, Marianne, Norrgren, Hans, Medstrand, Patrik
• Format: Article
• Language: English
• Subjects: Acquired Immunodeficiency Syndrome - drug therapy; Acquired Immunodeficiency Syndrome - mortality; Acquired Immunodeficiency Syndrome - pathology; Acquired Immunodeficiency Syndrome - virology; Adult; AIDS; Analytical estimating; Antiretroviral Therapy, Highly Active - methods; Biological and medical sciences; CD4-Positive T-Lymphocytes - immunology; CD4-Positive T-Lymphocytes - virology; CD8-Positive T-Lymphocytes - immunology; CD8-Positive T-Lymphocytes - virology; Disease Progression; Female; Fundamental and applied biological sciences. Psychology; Guinea-Bissau; HIV; HIV 1; HIV infections; HIV Infections - drug therapy; HIV Infections - mortality; HIV Infections - pathology; HIV Infections - virology; HIV-1 - drug effects; HIV-1 - genetics; HIV/AIDS; Human genetics; Human immunodeficiency virus 1; Human viral diseases; Humans; Infectious diseases; Male; Medical sciences; Microbiology; Middle Aged; Recombination, Genetic - genetics; T lymphocytes; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral load; Viruses
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/jit416

Background. Human immunodeficiency virus type 1 (HIV-1) is divided into subtypes and circulating recombinant forms (CRFs) but the impact of subtype/CRF on disease progression is not fully understood. Methods. We determined the HIV-1 subtype/CRF of 152 seroincident individuals from Guinea-Bissau, based on the C2-V3 region of env. Disease progression was measured as time from estimated seroconversion to AIDS and AIDS-related death. Hazard ratios (HRs) were calculated using a Cox proportional hazard model, adjusting for gender and age at seroconversion. Results. The major subtypes/CRFs identified were CRF02_ AG (53%), A3 (29%), and A3/02 (a recombinant of A3 and CRF02_ AG) (13%). Infection with A3/02 was associated with a close to 3-fold increased risk of AIDS and AIDS-related death compared to A3 (HR = 2.6 [P = 0.011] and 2.9 [P = 0.032], respectively). The estimated time from seroconversion to AIDS and AIDS-related death was 5.0 and 8.0 years for A3/02, 6.2 and 9.0 years for CRF02_ AG, and 7.2 and 11.3 years for A3. Conclusion. Our results show that there are differences in disease progression between HIV-1 A-like subtypes/CRFs. Individuals infected with A3/02 have among the fastest progression rates to AIDS reported to date. Determining the HIV-1 subtype of infected individuals could be important in the management of HIV-1 infections.