Disease progression by infecting HIV-1 subtype in a seroconverter cohort in sub-Saharan Africa.
<h4>Objective</h4> <p>To describe immunologic, virologic, and clinical HIV disease progression by HIV-1 subtype among Africans with well documented estimated dates of HIV infection (EDIs).</p> <h4>Design</h4> <p>Prospective cohort.</p> <h4>Method...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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Lippincott Williams and Wilkins
2013
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| _version_ | 1797075396829642752 |
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| author | Amornkul, P Karita, E Kamali, A Rida, W Sanders, E Lakhi, S Price, M Kilembe, W Cormier, E Anzala, O Latka, M Bekker, L Allen, S Gilmour, J Fast, P |
| author_facet | Amornkul, P Karita, E Kamali, A Rida, W Sanders, E Lakhi, S Price, M Kilembe, W Cormier, E Anzala, O Latka, M Bekker, L Allen, S Gilmour, J Fast, P |
| author_sort | Amornkul, P |
| collection | OXFORD |
| description | <h4>Objective</h4> <p>To describe immunologic, virologic, and clinical HIV disease progression by HIV-1 subtype among Africans with well documented estimated dates of HIV infection (EDIs).</p> <h4>Design</h4> <p>Prospective cohort.</p> <h4>Methods</h4> <p>Adults and youth with documented HIV-1 infection in the past 12 months were recruited from seroincidence cohorts in East and Southern Africa and followed at 3–6 month intervals. Blood for lymphocyte subset and viral load determination was collected at each visit.Pol was sequenced from the first positive specimen to ascertain subtype. Preantiretroviral therapy disease progression was measured by three time-toevent endpoints: CD4+ cell count 350 cells/µl or less, viral load measurement at least 1x10^5copies/ml, and clinical AIDS.</p> <h4>Results</h4> <p>From 2006 to 2011, 615 participants were enrolled at nine research centers in Kenya, Rwanda, South Africa, Uganda, and Zambia; 579 (94.1%) had viral subtyping completed. Predominant subtypes were C (256, 44.2%), A (209, 36.1%), and D (84, 14.5%). After adjustment for age, sex, and human leukocyte antigen alleles in Cox regression analyses, subtype C-infected participants progressed faster than subtype A to all three endpoints [CD4+ hazard ratio 1.60, 95% (confidence interval) CI 1.16, 2.20; viral load hazard ratio 1.59, 95% CI 1.12, 2.25; and AIDS hazard ratio 1.60, 95% CI 1.11, 2.31). Subtype D-infected participants reached high viral load more rapidly (hazard ratio 1.61, 95% CI 1.01, 2.57) and progressed nearly twice as fast to AIDS compared to subtype A (hazard ratio 1.93, 95% CI 1.21, 3.09).</p> <h4>Conclusion</h4> <p>Subtype-specific differences in HIV disease progression suggest that the local subtype distribution be considered when planning HIV programs and designing and defining clinical endpoints for HIV prevention trials.</p> |
| first_indexed | 2024-03-06T23:49:49Z |
| format | Journal article |
| id | oxford-uuid:72395783-9a5e-46fb-8cbb-6be285f9d10b |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T23:49:49Z |
| publishDate | 2013 |
| publisher | Lippincott Williams and Wilkins |
| record_format | dspace |
| spelling | oxford-uuid:72395783-9a5e-46fb-8cbb-6be285f9d10b2022-03-26T19:48:42ZDisease progression by infecting HIV-1 subtype in a seroconverter cohort in sub-Saharan Africa.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:72395783-9a5e-46fb-8cbb-6be285f9d10bEnglishSymplectic Elements at OxfordLippincott Williams and Wilkins2013Amornkul, PKarita, EKamali, ARida, WSanders, ELakhi, SPrice, MKilembe, WCormier, EAnzala, OLatka, MBekker, LAllen, SGilmour, JFast, P<h4>Objective</h4> <p>To describe immunologic, virologic, and clinical HIV disease progression by HIV-1 subtype among Africans with well documented estimated dates of HIV infection (EDIs).</p> <h4>Design</h4> <p>Prospective cohort.</p> <h4>Methods</h4> <p>Adults and youth with documented HIV-1 infection in the past 12 months were recruited from seroincidence cohorts in East and Southern Africa and followed at 3–6 month intervals. Blood for lymphocyte subset and viral load determination was collected at each visit.Pol was sequenced from the first positive specimen to ascertain subtype. Preantiretroviral therapy disease progression was measured by three time-toevent endpoints: CD4+ cell count 350 cells/µl or less, viral load measurement at least 1x10^5copies/ml, and clinical AIDS.</p> <h4>Results</h4> <p>From 2006 to 2011, 615 participants were enrolled at nine research centers in Kenya, Rwanda, South Africa, Uganda, and Zambia; 579 (94.1%) had viral subtyping completed. Predominant subtypes were C (256, 44.2%), A (209, 36.1%), and D (84, 14.5%). After adjustment for age, sex, and human leukocyte antigen alleles in Cox regression analyses, subtype C-infected participants progressed faster than subtype A to all three endpoints [CD4+ hazard ratio 1.60, 95% (confidence interval) CI 1.16, 2.20; viral load hazard ratio 1.59, 95% CI 1.12, 2.25; and AIDS hazard ratio 1.60, 95% CI 1.11, 2.31). Subtype D-infected participants reached high viral load more rapidly (hazard ratio 1.61, 95% CI 1.01, 2.57) and progressed nearly twice as fast to AIDS compared to subtype A (hazard ratio 1.93, 95% CI 1.21, 3.09).</p> <h4>Conclusion</h4> <p>Subtype-specific differences in HIV disease progression suggest that the local subtype distribution be considered when planning HIV programs and designing and defining clinical endpoints for HIV prevention trials.</p> |
| spellingShingle | Amornkul, P Karita, E Kamali, A Rida, W Sanders, E Lakhi, S Price, M Kilembe, W Cormier, E Anzala, O Latka, M Bekker, L Allen, S Gilmour, J Fast, P Disease progression by infecting HIV-1 subtype in a seroconverter cohort in sub-Saharan Africa. |
| title | Disease progression by infecting HIV-1 subtype in a seroconverter cohort in sub-Saharan Africa. |
| title_full | Disease progression by infecting HIV-1 subtype in a seroconverter cohort in sub-Saharan Africa. |
| title_fullStr | Disease progression by infecting HIV-1 subtype in a seroconverter cohort in sub-Saharan Africa. |
| title_full_unstemmed | Disease progression by infecting HIV-1 subtype in a seroconverter cohort in sub-Saharan Africa. |
| title_short | Disease progression by infecting HIV-1 subtype in a seroconverter cohort in sub-Saharan Africa. |
| title_sort | disease progression by infecting hiv 1 subtype in a seroconverter cohort in sub saharan africa |
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