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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Different rates of disease progression of HIV type 1 infection in Tanzania based on infecting subtype
Clinical Infectious Diseases, Volume 42, No. 6, Year 2006
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Description
Background. Many different subtypes of human immunodeficiency virus (HIV) type 1 have been identified, particularly in sub-Saharan Africa. However, much remains unknown regarding the relative pathogenicity of these subtypes and their influence on the clinical progression of HIV infection. We examined prospectively the associations between HIV-1 subtypes A, C, and D and recombinant viruses, as well as the rates of disease progression in a cohort of seropositive women from Dar es Salaam, Tanzania. Methods. A total of 428 pregnant mothers participating in a larger controlled trial of the effect of vitamin supplements were selected for DNA sequencing of their HIV-1 subtype. Plasma viral load was measured at baseline, and CD4+ cell counts was assessed at baseline and at regular intervals throughout the follow-up period. Proportional hazards regression (hazards ratio [HR]) analysis was used to measure the association between viral subtype and the rate of disease progression. Results. Relative to patients with subtype A, patients with subtype D experienced the most rapid progression to death (HR, 2.27; 95% confidence interval [CI], 1.46-3.52) or to the World Health Organization stage 4 of illness (HR, 1.94; 95% CI, 1.20-3.14) and to a CD4+ cell count of <200 cells/mm3 (HR, 2.12; 95% CI, 1.42-3.17). After adjustment for viral load, CD4+ cell count, and other baseline covariates, the associations remained similar. Conclusions. We observed heterogeneity in the rates of disease progression of HIV-1 disease in infected persons, on the basis of the infecting subtype. Subtype D was associated with the most rapid progression of the disease, relative to the other 3 categories of viruses in our cohort. © 2006 by the Infectious Diseases Society of America. All rights reserved.
Authors & Co-Authors
Vasan, Ashwin
United States, Boston
Harvard T.h. Chan School of Public Health Aids Initiative
Switzerland, Geneva
Organisation Mondiale de la Santé
Renjifo, Boris R.
United States, Boston
Harvard T.h. Chan School of Public Health Aids Initiative
Hertzmark, Ellen
United States, Boston
Harvard T.h. Chan School of Public Health Aids Initiative
Chaplin, Beth R.
United States, Boston
Harvard T.h. Chan School of Public Health Aids Initiative
Msamanga, Gernard I.
Unknown Affiliation
Essex, Max E.
United States, Boston
Harvard T.h. Chan School of Public Health Aids Initiative
Fawzi, Wafaie W.
United States, Boston
Harvard T.h. Chan School of Public Health Aids Initiative
Hunter, D. J.
United States, Boston
Harvard T.h. Chan School of Public Health Aids Initiative
United States, Boston
Brigham and Women's Hospital
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Statistics
Citations: 202
Authors: 8
Affiliations: 4
Identifiers
Doi:
10.1086/499952
ISSN:
10584838
Research Areas
Genetics And Genomics
Infectious Diseases
Maternal And Child Health
Study Design
Cohort Study
Study Locations
Tanzania
Participants Gender
Female