Clinical differences and viral diversity between newly HIV type 1-diagnosed African and non-African patients in Spain (2005-2007).
Abstract The diagnosis of HIV-1 is increasing in African-born persons residing in Europe. They present a high prevalence of HIV-1 non-B variant infections and of parasitic infections, both of which are infrequent in Western countries. Immigration favors their presence in nonendemic countries. In this study, all newly HIV-diagnosed individuals at an HIV/AIDS and Tropical Medicine reference center in Madrid from 2005 through 2007 were retrospectively studied. HIV-1 subtyping was performed in gag, pol, and gp41 coding regions by phylogenetic analyses. The presence of other pathogens was also evaluated. Furthermore, all HIV-1-infected Africans were screened for parasitic infections. Newly diagnosed HIV-1 subjects included 90 sub-Saharan Africans and 188 non-Africans (116 Spaniards, 13 other Europeans, and 59 Latin Americans). Significantly higher numbers of HIV-1-infected Africans than non-Africans were females, acquired HIV-1 by heterosexual contact, and presented a more advanced clinical CDC stage and criteria for starting antiretroviral therapy in the first clinical visit. They predominantly carried non-B subtype infections, mainly intersubtype recombinants. Half of HIV-1-infected Africans had parasitic infections. CD4(+) T cell counts were lower among Africans than Europeans at the time of HIV-1 diagnosis. At 12 months of follow-up after starting antiretroviral treatment, a significantly lower proportion of Africans than non-Africans achieved undetectable viremia due to their higher loss to follow-up. However, CD4(+) T cell recovery and virological failure rates were similar. Therefore, the profile of African HIV-1-infected immigrants varies widely with respect to Spanish HIV-infected individuals. More advanced immunodeficiency and the coexistence of parasitic diseases and infections with a large diversity of HIV-1 non-B and recombinant variants are expected.
Yebra
Gonzalo
G
HIV-1 Molecular Epidemiology Laboratory, Service of Microbiology, Hospital Ramón y Cajal and CIBER-ESP , Madrid, Spain.
Rivas
Pablo
P
Herrero
María Dolores
MD
López
Marisa
M
de Mulder
Miguel
M
Puente
Sabino
S
Ramírez-Olivencia
Germán
G
Soriano
Vincent
V
Holguín
Africa
A
D000328:Adult; D000818:Animals; D018791:CD4 Lymphocyte Count; D016000:Cluster Analysis; D005006:Ethnicity; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology / Q000821:virology*; D015497:HIV-1 / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D010802:Phylogeny; D011110:Polymorphism, Genetic; D012189:Retrospective Studies; D017422:Sequence Analysis, DNA; D017385:Sequence Homology; D013030:Spain / Q000453:epidemiology; D019562:Viral Load; D014764:Viral Proteins / Q000235:genetics
D014764:Viral Proteins