The effects of HIV-1 subtype and ethnicity on the rate of CD4 cell count decline in patients naive to antiretroviral therapy: a Canadian-European collaborative retrospective cohort study

Klein, Marina B.; Young, Jim; Dunn, David; Ledergerber, Bruno; Sabin, Caroline; Cozzi‐Lepri, Alessandro; Dabis, François; Harrigan, Richard; Tan, Darrell H. S.; Walmsley, Sharon; Gill, John; Cooper, Curtis; Scherrer, Alexandra U.; Mocroft, Amanda; Hogg, Robert S.; Smaill, Fiona

doi:10.9778/cmajo.20140017

Cited by 17 publications

(10 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The majority of studies examining association of HIV-1 subtype with patient outcomes have largely focused on subtype B, the commonest variant in the USA and Western Europe and one that represents less than 15% of HIV-1 infections worldwide. Few studies have PLOS ONE evaluated the effect of HIV subtypes for periods longer than 48 weeks and these were on ARV naïve HIV infected subjects [13,[24][25][26]. In this study, we examined the subtype distribution and the effect of these subtypes on disease outcome over a 5-year period in a cohort of patients receiving ART in a large teaching hospital location in southwest Nigeria.…”

Section: Resultsmentioning

confidence: 99%

The impact of HIV-1 subtypes on virologic and immunologic treatment outcomes at the Lagos University Teaching Hospital: A longitudinal evaluation

et al. 2020

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 99%

The impact of HIV-1 subtypes on virologic and immunologic treatment outcomes at the Lagos University Teaching Hospital: A longitudinal evaluation

et al. 2020

View full text Add to dashboard Cite

show abstract

“…HIV subtypes may also have differential characteristics, such as replication fitness and biology of transmission, which could impact disease progression and response to therapy [21,22,[24][25][26]. However, to date this has not been definitively proven in clinical cohorts due to confounders such as sex, ethnicity and heterogeneity in time intervals since seroconversion [46][47][48]. Gender-matched studies will be necessary to determine whether sex or viral subtype is the major driver of our results as our non-African cohort were all male.…”

Section: Discussionmentioning

confidence: 98%

Virological remission after antiretroviral therapy interruption in female African HIV seroconverters

Gossez

Martin

Pace

et al. 2019

Aids

View full text Add to dashboard Cite

a,h,i , on behalf of the SPARTAC Trial Investigators Introduction: There are few data on the frequency of virological remission in African individuals after treatment with antiretroviral therapy (ART) in primary HIV infection (PHI). Methods: We studied participants (n ¼ 82) from South Africa and Uganda in Short Pulse Antiretroviral Treatment at HIV-1 Seroconversion, the first trial of treatment interruption in African individuals with PHI randomized to deferred ART or 48 weeks of immediate ART. All were female and infected with non-B HIV subtypes, mainly C. We measured HIV DNA in CD4 þ T cells, CD4 þ cell count, plasma viral load (pVL), cell-associated HIV RNA and T-cell activation and exhaustion. We explored associations with clinical progression and time to pVL rebound after treatment interruption (n ¼ 22). Data were compared with non-African Short Pulse Antiretroviral Treatment at HIV-1 Seroconversion participants. Results: Pretherapy pVL and integrated HIV DNA were lower in Africans compared with non-Africans (median 4.16 vs. 4.72 log 10 copies/ml and 3.07 vs. 3.61 log 10 copies/ million CD4 þ T cells, respectively; P < 0.001). Pre-ART HIV DNA in Africans was associated with clinical progression (P ¼ 0.001, HR per log 10 copies/million CD4 þ T cells increase (95% CI) 5.38 (1.95-14.79)) and time to pVL rebound (P ¼ 0.034, HR per log 10 copies/ml increase 4.33 (1.12-16.84)). After treatment interruption, Africans experienced longer duration of viral remission than non-Africans (P < 0.001; HR 3.90 (1.75-8.71). Five of 22 African participants (22.7%) maintained VL less than 400 copies/ml over a median of 188 weeks following treatment interruption. Conclusion: We find evidence of greater probability of virological remission following treatment interruption among African participants, although we are unable to differentiate between sex, ethnicity and viral subtype. The finding warrants further investigation.

show abstract

“…+ T-cell slope trajectories (referred to as 'the slope') for people with known last negative and first positive HIV tests were built on the square root of CD4 + T-cell counts modelled through a maximum likelihood multilevel linear approach[19][20][21][22][23]. Since people in this cohort might present at the time of seroconversion, an 'anchor' date 3 months after HIV diagnosis was set as the CD4 + T-cell count (where the person remained treatment-naive) to remove the bias of capturing a seroconversion-induced low CD4 + T-cell count (Supplement).…”

mentioning

confidence: 99%

Post-migration acquisition of HIV: Estimates from four European countries, 2007 to 2016

et al. 2021

View full text Add to dashboard Cite

Background The assumption that migrants acquire human immunodeficiency virus (HIV) before migration, particularly those from high prevalence areas, is common. Aim We assessed the place of HIV acquisition of migrants diagnosed in four European countries using surveillance data. Methods Using CD4+ T-cell count trajectories modelled to account for seroconversion bias, we estimated infection year of newly HIV-diagnosed migrants residing in the United Kingdom (UK), Belgium, Sweden and Italy with a known arrival year and CD4+ T-cell count at diagnosis. Multivariate analyses identified predictors for post-migration acquisition. Results Between 2007 and 2016, migrants constituted 56% of people newly diagnosed with HIV in the UK, 62% in Belgium, 72% in Sweden and 29% in Italy. Of 23,595 migrants included, 60% were born in Africa and 70% acquired HIV heterosexually. An estimated 9,400 migrants (40%; interquartile range (IQR): 34–59) probably acquired HIV post-migration. This proportion was similar by risk group, sex and region of birth. Time since migration was a strong predictor of post-migration HIV acquisition: 91% (IQR: 87–95) among those arriving 10 or more years prior to diagnosis; 30% (IQR: 21–37) among those 1–5 years prior. Younger age at arrival was a predictor: 15–18 years (81%; IQR: 74–86), 19–25 years (53%; IQR: 45–63), 26–35 years (37%; IQR: 30–46) and 36 years and older (25%; IQR: 21–33). Conclusions Migrants, regardless of origin, sex and exposure to HIV are at risk of acquiring HIV post-migration to Europe. Alongside accessible HIV testing, prevention activities must target migrant communities.

show abstract

The effects of HIV-1 subtype and ethnicity on the rate of CD4 cell count decline in patients naive to antiretroviral therapy: a Canadian-European collaborative retrospective cohort study

Cited by 17 publications

References 36 publications

The impact of HIV-1 subtypes on virologic and immunologic treatment outcomes at the Lagos University Teaching Hospital: A longitudinal evaluation

The impact of HIV-1 subtypes on virologic and immunologic treatment outcomes at the Lagos University Teaching Hospital: A longitudinal evaluation

Virological remission after antiretroviral therapy interruption in female African HIV seroconverters

Post-migration acquisition of HIV: Estimates from four European countries, 2007 to 2016

Contact Info

Product

Resources

About