Abstract
To assess whether human immunodeficiency virus type 1 (HIV-1) genotype influences baseline CD4+ T lymphocyte (CD4+) cell count and mortality of patients. The study was conducted from 2014 to 2019 in Guangxi, China, and included 2845 newly diagnosed HIV patients. We used a median regression model to compare CD4+ cell counts in patients newly diagnosed with different HIV-1 genotypes, and a Cox regression model to analyze the associations between HIV-1 genotypes and mortality before and after antiretroviral treatment (ART). In newly diagnosed HIV patients, the baseline CD4+ cell counts of patients with CRF01_AE were significantly lower than those of patients with CRF07_BC, CRF08_BC, and other genotypes. Compared with CRF01_AE, patients infected with CRF07_BC (hazard ratio, 0.55; 95% CI 0.36–0.85), CRF08_BC (hazard ratio, 0.67; 95% CI 0.52–0.85), or other genotypes (hazard ratio, 0.52; 95% CI 0.29–0.94) had significantly lower mortality rates before ART. There were no significant associations between different HIV-1 genotypes and mortality after ART. HIV-1 genotype significantly influences baseline CD4+ cell count and mortality before ART in newly diagnosed HIV patients. We find no significant difference in the outcome of death after ART in patients with different HIV-1 genotypes.
Highlights
To assess whether human immunodeficiency virus type 1 (HIV-1) genotype influences baseline CD4+ T lymphocyte (CD4+) cell count and mortality of patients
Human immunodeficiency virus (HIV)-1 group M is further divided into distinct genotypes, namely A, B, C, D, F, G, H, J, and K, as well as hybrids resulting from recombination between genotypes, known as circulating recombinant forms (CRFs) or unique recombinant forms (URFs)[2,3]
Of the 6,078 HIV patients who were newly diagnosed between January 1, 2014 and April 30, 2019, 3237 had blood samples available in storage for HIV-1 genotype analysis after western blotting (WB) confirmation tests
Summary
To assess whether human immunodeficiency virus type 1 (HIV-1) genotype influences baseline CD4+ T lymphocyte (CD4+) cell count and mortality of patients. In China, studies showed that CRF01_AE is associated with faster disease progression from estimated seroconversion to acquired immune deficiency syndrome (AIDS) compared with non-CRF01_AE in ART-naïve p atients[10,11]. Using mortality as a study end point for either ART-naïve participants or those on ART This question is urgent with respect to HIV-1 epidemic in China, as transmission accounts for more than 90% of cases, resulting in infections by CRF07_BC, CRF08_BC, and multilineages of CRF01_AE; this is distinct from the single lineage epidemic of B genotype prevalent in European countries[12,13,15,16]. This study was performed to investigate the effects of HIV-1 genotype on baseline CD4+ cell counts and mortality, before and after ART, among newly diagnosed HIV patients. We found that CRF01_AE was significantly associated with a lower baseline CD4+ count and higher mortality before ART treatment, and that combination ART treatment is efficient among HIV patients regardless of their HIV-1 genotype
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