HIV disease progression and V3 serotypes in Brazil: is B different from B-Br?
HIV-1 serotype B-Br (GWGR) is rare in the United States but predominates in Brazil. Differences in prognosis for patients infected with serotype B-Br or serotype B (GPGR) have not been addressed previously. In this prospective cohort study, we compared the rate of disease progression between patients infected with the HIV-1 V3 serotype B or B-Br in Brazil. Progression to AIDS or death was studied by the Kaplan-Meier and Cox proportional hazard methods. Among 445 HIV-infected patients who were tested with a specific enzyme immune assay, 204 (46%) had serotype B-Br infection and 127 (28%) had serotype B infection. Both groups were similar with regard to baseline CD4+ cell count, serum HIV RNA viral load, initial clinical stage, and the proportions who were treated with antiretroviral drugs. Patients with serotype B infection were significantly younger (p = 0.005) and tended to report homosexual behavior more frequently (p = 0.08). Mean follow-up was 30 +/- 13.5 months. During the study period, 41 (32%) patients infected with serotype B and 44 (22%) infected with serotype B-Br developed AIDS (p = 0.03). In a regression model adjusted for age and risk factor for HIV infection, progression to AIDS was faster in patients infected with serotype B (hazard ratio [HR] 1.59; 95% CI, 1.03-2.43; p = 0.03). A similar trend was observed in a model that considered AIDS or death as the outcome (HR, 1.43; 95% CI, 0.95-2.0; p = 0.09). These results suggest that patients infected with closely related HIV-1 serotypes may differ in the rate of progression to AIDS and indicate that serotype should be taken into account in HIV vaccine studies in Brazil.
Santoro-Lopes
G
G
Infectious Diseases Clinic, Department of Preventive Medicine, Hospital Universitário Clementino Fraga Filho, Federal University of Rio de Janeiro, Brazil.
Harrison
L H
LH
Tavares
M D
MD
Xexéo
A
A
Dos Santos
A C
AC
Schechter
M
M
D000163:Acquired Immunodeficiency Syndrome / Q000503:physiopathology / Q000821:virology*; D001938:Brazil; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D015699:HIV Envelope Protein gp120 / Q000276:immunology*; D015658:HIV Infections / Q000401:mortality / Q000503:physiopathology* / Q000821:virology*; D015497:HIV-1 / Q000145:classification* / Q000235:genetics / Q000276:immunology / Q000502:physiology*; D006801:Humans; D008297:Male; D010446:Peptide Fragments / Q000276:immunology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012703:Serotyping
D015699:HIV Envelope Protein gp120; C059762:HIV envelope protein gp120 (305-321); D010446:Peptide Fragments