J Infect Dis. 2013 Aug 30. [Epub ahead of print] Faster Progression to AIDS and AIDS-Related Death Among Seroincident Individuals Infected With Recombinant HIV-1 A3/CRF02_AG Compared With Sub-subtype A3.
Palm AA, Esbjörnsson J, Månsson F, Kvist A, Isberg PE, Biague A, da Silva ZJ, Jansson M, Norrgren H, Medstrand P.
Source
Department of Experimental Medical Science Lund.Abstract
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.
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