UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Switch of predicted HIV-1 tropism in treated subjects and its association with disease progression

Castagna, A; Monno, L; Carta, S; Galli, L; Carrara, S; Fedele, V; Punzi, G; ... Monforte, AD; + view all (2016) Switch of predicted HIV-1 tropism in treated subjects and its association with disease progression. Medicine , 95 (44) , Article e5222. 10.1097/MD.0000000000005222. Green open access

[img]
Preview
Text
Cozzi-Lepri_Switch of predicted HIV-1 tropism in treated subject and its association with disease progression.pdf - Published version

Download (246kB) | Preview

Abstract

Abstract: Dynamics of human immunodeficiency virus type 1 (HIV-1) tropism after antiretroviral therapy (ART) initiation and their association with disease progression are poorly investigated. This was a cohort study on subjects from the ICONA cohort receiving ART with persistently detectable (PD) or persistently undetectable (PU) viral load (VL) and with stored plasma or peripheral blood mononuclear cell (PBMC) samples at 2 time-points (T1, T2) after ART initiation. HIV-1 co-receptor tropism was determined by V3-loop sequencing and the geno2pheno algorithm. A switch in viral tropism was defined if the tropism classification at T2 differed from that observed at T1. Time to disease progression, defined as the occurrence of a new acquired immune deficiency syndrome (AIDS)-defining event/death from T2, was also evaluated. One hundred ninety-five patients were analyzed (124 PD, 71 PU). Over a median follow-up of 22.6 (19.8–28.1) months, PD and PU patients showed similar rates (95% confidence interval) of switch to a non-R5 virus [PD: 6.9 (3.7–11.2)/100-person-years of follow-up (PYFU); PU: 8.0 (3.4–14.5)/100-PYFU; P = 0.63] and of switch to a R5 virus [PD: 15.4 (7.3–26.4)/100-PYFU; PU: 8.1 (2.5–16.7)/100-PYFU; P = 0.38]. Switch to non-R5 virus was predicted by nadir CD4+ before T1. Twenty-two (18%) PD and 4 (6%) PU subjects experienced disease progression (P = 0.02). The risk of disease progression was independently associated with a switch in co-receptor tropism (adjusted hazard ratio = 4.06, 95% CI: 1.20–13.80, P = 0.03) as well as age, AIDS diagnosis, nadir CD4+ before T2, current CD4+, and VL. Switch of HIV-1 tropism under ART occurs in both directions, with similar rates in subjects with PD or PU VL and it might be predictive of future unfavorable clinical outcome.

Type: Article
Title: Switch of predicted HIV-1 tropism in treated subjects and its association with disease progression
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/MD.0000000000005222
Publisher version: http://dx.doi.org/10.1097/MD.0000000000005222
Language: English
Additional information: CCR5; disease progression; FPR; HIV; tropism switch
Keywords: Science & Technology, Life Sciences & Biomedicine, Medicine, General & Internal, General & Internal Medicine, CCR5, Disease Progression, FPR, HIV, Tropism Switch, Combination Antiretroviral Therapy, CD4 Cell Count, Coreceptor Tropism, Infected Patients, Virological Failure, Proviral Dna, Evolution, Impact, Usage, Load
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/1533200
Downloads since deposit
69Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item