Effect of human immunodeficiency virus (HIV) type 1 envelope subtypes A and D on disease progression in a large cohort of HIV-1-positive persons in Uganda.
The effect of human immunodeficiency virus (HIV) type 1 envelope subtypes A and D on disease progression was investigated in 1045 adults in Uganda. At enrollment and every 6 months, a clinical history, examination, and laboratory investigations that included CD4 cell counts were done. HIV-1 envelope subtype was assessed mainly by peptide serology supplemented by heteroduplex mobility assay and DNA sequencing. A multivariate analysis of survival was performed to assess the prognostic value of HIV-1 subtype on death. A marginal general linear model also determined the effect of subtype on CD4 cell count during follow-up. Subtype D was associated with faster progression to death (relative risk, 1.29; 95% confidence interval, 1.07-1.56; P=.009) and with a lower CD4 cell count during follow-up (P=.001), compared with subtype A, after adjusting for CD4 cell count at enrollment. In Africa, envelope subtype D is associated with faster disease progression, compared with subtype A.
Kaleebu
Pontiano
P
Medical Research Council Programme on AIDS, Uganda Virus Research Institute, Entebbe, Uganda. mrc@starcom.co.ug
French
Neil
N
Mahe
Cedric
C
Yirrell
David
D
Watera
Christine
C
Lyagoba
Fred
F
Nakiyingi
Jessica
J
Rutebemberwa
Alleluiah
A
Morgan
Dilys
D
Weber
Jonathan
J
Gilks
Charles
C
Whitworth
Jimmy
J
D000163:Acquired Immunodeficiency Syndrome / Q000276:immunology / Q000401:mortality / Q000821:virology*; D000328:Adult; D000368:Aged; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D015497:HIV-1 / Q000145:classification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014454:Uganda