Cargando…
Increased Rate of CD4+ T-Cell Decline and Faster Time to Antiretroviral Therapy in HIV-1 Subtype CRF01_AE Infected Seroconverters in Singapore
BACKGROUND: It remains controversial as to whether HIV-1 subtypes influence disease progression. Singapore offers a unique opportunity to address this issue due to the presence of co-circulating subtypes. We compared subtype CRF01_AE and non-CRF01_AE infected patients, with regards to estimated annu...
Autores principales: | , , , , , , |
---|---|
Formato: | Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2011
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3029292/ https://www.ncbi.nlm.nih.gov/pubmed/21298051 http://dx.doi.org/10.1371/journal.pone.0015738 |
_version_ | 1782197216943800320 |
---|---|
author | Ng, Oon Tek Lin, Li Laeyendecker, Oliver Quinn, Thomas C. Sun, Yong Jiang Lee, Cheng Chuan Leo, Yee Sin |
author_facet | Ng, Oon Tek Lin, Li Laeyendecker, Oliver Quinn, Thomas C. Sun, Yong Jiang Lee, Cheng Chuan Leo, Yee Sin |
author_sort | Ng, Oon Tek |
collection | PubMed |
description | BACKGROUND: It remains controversial as to whether HIV-1 subtypes influence disease progression. Singapore offers a unique opportunity to address this issue due to the presence of co-circulating subtypes. We compared subtype CRF01_AE and non-CRF01_AE infected patients, with regards to estimated annual rate of CD4+ T-cell loss and time from estimated data of seroconversion (EDS) to antiretroviral therapy (ART). METHODS: We recruited ART-naive patients with known dates of seroconversion between October 2002 and December 2007 at the Singapore Communicable Disease Centre, the national reference treatment centre. Multilevel mixed-effects models were used to analyse the rate of CD4+ T-cell decline. Time from EDS to ART was analyzed with the Kaplan-Meier survival method and compared with Cox proportional hazards models. RESULTS: 54 patients with previously assigned HIV-1 subtypes (24 CRF01_AE, 17 B, 8 B', 1 CRF33_01B, 3 CRF34_01B and 1 G) were observed for 89 patient-years. Subtype CRF01_AE and non-CRF01_AE infected patients did not differ in age, gender, risk factor, rate of symptomatic seroconversion, baseline CD4+ T-cell count, log(10) viral load or haemoglobin concentration. The estimated annual rate of CD4+ T-cell loss was 58 cells/mm(3)/year (95% CI: 7 to 109; P = 0.027) greater in subtype CRF01_AE infected patients compared to non-CRF01_AE patients, after adjusting for age, baseline CD4+ T-cell count and baseline log(10) viral load. The median time from EDS to ART was 1.8 years faster comparing CRF01_AE to non-CRF01_AE infected patient with a 2.5 times (95% CI: 1.2-5.0; P = 0.013) higher hazard for ART initiation, after controlling for age, baseline CD4+ T-cell count and baseline log(10) viral load. CONCLUSIONS: Infecting subtype significantly impacted the rate of CD4+ T-cell loss and time to treatment in this cohort. Studies to understand the biological basis for this difference could further our understanding of HIV pathogenesis. |
format | Text |
id | pubmed-3029292 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-30292922011-02-04 Increased Rate of CD4+ T-Cell Decline and Faster Time to Antiretroviral Therapy in HIV-1 Subtype CRF01_AE Infected Seroconverters in Singapore Ng, Oon Tek Lin, Li Laeyendecker, Oliver Quinn, Thomas C. Sun, Yong Jiang Lee, Cheng Chuan Leo, Yee Sin PLoS One Research Article BACKGROUND: It remains controversial as to whether HIV-1 subtypes influence disease progression. Singapore offers a unique opportunity to address this issue due to the presence of co-circulating subtypes. We compared subtype CRF01_AE and non-CRF01_AE infected patients, with regards to estimated annual rate of CD4+ T-cell loss and time from estimated data of seroconversion (EDS) to antiretroviral therapy (ART). METHODS: We recruited ART-naive patients with known dates of seroconversion between October 2002 and December 2007 at the Singapore Communicable Disease Centre, the national reference treatment centre. Multilevel mixed-effects models were used to analyse the rate of CD4+ T-cell decline. Time from EDS to ART was analyzed with the Kaplan-Meier survival method and compared with Cox proportional hazards models. RESULTS: 54 patients with previously assigned HIV-1 subtypes (24 CRF01_AE, 17 B, 8 B', 1 CRF33_01B, 3 CRF34_01B and 1 G) were observed for 89 patient-years. Subtype CRF01_AE and non-CRF01_AE infected patients did not differ in age, gender, risk factor, rate of symptomatic seroconversion, baseline CD4+ T-cell count, log(10) viral load or haemoglobin concentration. The estimated annual rate of CD4+ T-cell loss was 58 cells/mm(3)/year (95% CI: 7 to 109; P = 0.027) greater in subtype CRF01_AE infected patients compared to non-CRF01_AE patients, after adjusting for age, baseline CD4+ T-cell count and baseline log(10) viral load. The median time from EDS to ART was 1.8 years faster comparing CRF01_AE to non-CRF01_AE infected patient with a 2.5 times (95% CI: 1.2-5.0; P = 0.013) higher hazard for ART initiation, after controlling for age, baseline CD4+ T-cell count and baseline log(10) viral load. CONCLUSIONS: Infecting subtype significantly impacted the rate of CD4+ T-cell loss and time to treatment in this cohort. Studies to understand the biological basis for this difference could further our understanding of HIV pathogenesis. Public Library of Science 2011-01-27 /pmc/articles/PMC3029292/ /pubmed/21298051 http://dx.doi.org/10.1371/journal.pone.0015738 Text en This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. https://creativecommons.org/publicdomain/zero/1.0/ This is an open-access article distributed under the terms of the Creative Commons Public Domain declaration, which stipulates that, once placed in the public domain, this work may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. |
spellingShingle | Research Article Ng, Oon Tek Lin, Li Laeyendecker, Oliver Quinn, Thomas C. Sun, Yong Jiang Lee, Cheng Chuan Leo, Yee Sin Increased Rate of CD4+ T-Cell Decline and Faster Time to Antiretroviral Therapy in HIV-1 Subtype CRF01_AE Infected Seroconverters in Singapore |
title | Increased Rate of CD4+ T-Cell Decline and Faster Time to Antiretroviral Therapy in HIV-1 Subtype CRF01_AE Infected Seroconverters in Singapore |
title_full | Increased Rate of CD4+ T-Cell Decline and Faster Time to Antiretroviral Therapy in HIV-1 Subtype CRF01_AE Infected Seroconverters in Singapore |
title_fullStr | Increased Rate of CD4+ T-Cell Decline and Faster Time to Antiretroviral Therapy in HIV-1 Subtype CRF01_AE Infected Seroconverters in Singapore |
title_full_unstemmed | Increased Rate of CD4+ T-Cell Decline and Faster Time to Antiretroviral Therapy in HIV-1 Subtype CRF01_AE Infected Seroconverters in Singapore |
title_short | Increased Rate of CD4+ T-Cell Decline and Faster Time to Antiretroviral Therapy in HIV-1 Subtype CRF01_AE Infected Seroconverters in Singapore |
title_sort | increased rate of cd4+ t-cell decline and faster time to antiretroviral therapy in hiv-1 subtype crf01_ae infected seroconverters in singapore |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3029292/ https://www.ncbi.nlm.nih.gov/pubmed/21298051 http://dx.doi.org/10.1371/journal.pone.0015738 |
work_keys_str_mv | AT ngoontek increasedrateofcd4tcelldeclineandfastertimetoantiretroviraltherapyinhiv1subtypecrf01aeinfectedseroconvertersinsingapore AT linli increasedrateofcd4tcelldeclineandfastertimetoantiretroviraltherapyinhiv1subtypecrf01aeinfectedseroconvertersinsingapore AT laeyendeckeroliver increasedrateofcd4tcelldeclineandfastertimetoantiretroviraltherapyinhiv1subtypecrf01aeinfectedseroconvertersinsingapore AT quinnthomasc increasedrateofcd4tcelldeclineandfastertimetoantiretroviraltherapyinhiv1subtypecrf01aeinfectedseroconvertersinsingapore AT sunyongjiang increasedrateofcd4tcelldeclineandfastertimetoantiretroviraltherapyinhiv1subtypecrf01aeinfectedseroconvertersinsingapore AT leechengchuan increasedrateofcd4tcelldeclineandfastertimetoantiretroviraltherapyinhiv1subtypecrf01aeinfectedseroconvertersinsingapore AT leoyeesin increasedrateofcd4tcelldeclineandfastertimetoantiretroviraltherapyinhiv1subtypecrf01aeinfectedseroconvertersinsingapore |