HIV
and Hepatitis.com Coverage of the 14th
Annual Conference on Retroviruses and Opportunistic Infections (14th CROI) February
25 - 28, 2007, Los Angeles, CA
Women
with Subtype D HIV-1 are More Likely to Die and Experience Faster CD4 Cell Decline
It is not known
whether different strains and subtypes of HIV-1 influence the rate of disease
progression. While some studies have found that individuals infected with non-A
subtypes -- particularly subtype D -- appear to progress faster than those infected
with subtype A, others have not shown significant differences.
In a study
presented at the 14th Conference on Retroviruses and Opportunistic Infections
last month in Los Angeles, researchers investigated the effect of HIV-1 subtype
differences on disease progression among 218 female sex workers in Mombasa, Kenya,
who were followed for a median of 5.4 years from the time of seroconversion; genotypic
analysis was performed on HIV samples from 147 women.
Results
•
Of the 147 women, 114 had HIV-1 subtype A (78%), 21 (14%) had subtype D, 10 (7%)
had subtype C, and 2 had recombinant virus.
•
Among the 30 women
who died, 20 were infected with subtype A, 7 with subtype D, and 3 with subtype
C.
•
Compared to those with
subtype A, women with subtype D had significantly higher mortality and a faster
rate of CD4 cell decline.
•
The increased risk
of death persisted after adjusting for plasma HIV viral load.
•
Women with subtype
C also had a higher risk of death, but numbers were too small to achieve statistical
significance.
•
There were no significant
differences in plasma viral load associated with HIV subtype during follow-up.
Conclusion
The researchers concluded that, "Among this cohort of Kenyan
women followed from the time of HIV-1 acquisition, infection with HIV-1 subtype
D was associated with a faster rate of CD4 [cell] decline and a > 2-fold higher
risk of death than with subtype A infection, in spite of similar HIV-1 plasma
viral loads." Univ of Washington, Seattle, WA; Univ of Nairobi,
Kenya; Coast Provincial Gen Hosp, Mombasa, Kenya; and Fred Hutchinson Cancer Res
Ctr, Seattle, WA. Link
to full study abstract
03/16/07
Reference J
Baeten, B Chohan, L Lavreys, and others. HIV-1 Subtype D Infection Is Associated
with Faster Disease Progression than Subtype A, in Spite of Similar HIV-1 Plasma
Viral Loads. 14th Conference on Retroviruses and Opportunistic Infections. February
25-28, 2007. Los Angeles, CA. Abstract 68 (oral).
