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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Association of pol diversity with antiretroviral treatment outcomes among HIV-infected african children
PLoS ONE, Volume 8, No. 11, Article e81213, Year 2013
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Description
Background: In HIV-infected children, viral diversity tends to increase with age in the absence of antiretroviral treatment (ART). We measured HIV diversity in African children (ages 6-36 months) enrolled in a randomized clinical trial comparing two ART regimens (Cohort I of the P1060 trial). Children in this cohort were exposed to single dose nevirapine (sdNVP) at birth. Methods: HIV diversity was measured retrospectively using a high resolution melting (HRM) diversity assay. Samples were obtained from 139 children at the enrollment visit prior to ART initiation. Six regions of the HIV genome were analyzed: two in gag , one in pol , and three in env. A single numeric HRM score that reflects HIV diversity was generated for each region; composite HRM scores were also calculated (mean and median for all six regions). Results: In multivariable median regression models using backwards selection that started with demographic and clinical variables, older age was associated with higher HRM scores (higher HIV diversity) in pol (P = 0.005) and with higher mean (P = 0.014) and median (P<0.001) HRM scores. In multivariable models adjusted for age, pre-treatment HIV viral load, pre-treatment CD4%, and randomized treatment regimen, higher HRM scores in pol were associated with shorter time to virologic suppression (P = 0.016) and longer time to study endpoints (virologic failure [VF], VF/death, and VF/off study treatment; P<0.001 for all measures). Conclusions: In this cohort of sdNVP-exposed, ART-naïve African children, higher levels of HIV diversity in the HIV pol region prior to ART initiation were associated with better treatment outcomes. © 2013 Chen et al.
Authors & Co-Authors
Chen, Iris
Unknown Affiliation
Khaki, Leila
Unknown Affiliation
Lindsey, Jane C.
Unknown Affiliation
Fry, Carrie
Unknown Affiliation
Cousins, Matthew M.
Unknown Affiliation
Siliciano, Robert F.
Unknown Affiliation
Violari, Avy
Unknown Affiliation
Palumbo, Paul E.
Unknown Affiliation
Eshleman, Susan H.
Unknown Affiliation
Statistics
Citations: 9
Authors: 9
Affiliations: 6
Identifiers
Doi:
10.1371/journal.pone.0081213
e-ISSN:
19326203
Research Areas
Infectious Diseases
Maternal And Child Health
Study Design
Randomised Control Trial
Cohort Study