Rapid CD4+ T-cell decline is associated with coreceptor switch among MSM primarily infected with HIV-1 CRF01

DOI：

10.1097/qad.0000000000001981

发表时间：

2019-01-02

期刊：

AIDS

影响因子：

3.8

通讯作者：

中科院分区：

医学2区

文献类型：

作者：

Cui, Hualu;Geng, Wenqing;Shang, Hong

目的：CRF01_AE是中国MSM人群中最流行的HIV-1亚型。然而，crf01_ae感染的男男性接触者CD4(+) t细胞加速下降的特征和潜在机制尚不完全清楚。设计：对中国东北地区1388名HIV-1感染高危男男性行为者进行长期前瞻性随访研究。研究人员对原发HIV-1 CRF01_AE感染的男男性行为者进行了3-6年的随访，以探索CD4(+) t细胞快速下降的决定因素。方法：采用基于单基因组扩增的四种不同算法的基因型预测和临床分离株的表型测定来确定原发性感染的嗜性。用系列分离物测定共受体开关的表型。测定人白细胞抗原基因型和t细胞活化标记物。结果：共发现59例主要感染HIV-1 CRF01_AE的男男性行为者，纳入随访研究。东北地区HIV-1 CRF01_AE感染中，利用ccr5 （R5）的病毒占98%。生存分析显示39.5%的患者在感染后3年内发生了辅助受体转换。在对其他潜在危险因素进行调整后，线性混合效应模型显示，与没有辅助受体转换的患者相比，感染后3年内经历R5到cxcr4 /双向（X4/DM）辅助受体转换的患者CD4(+) t细胞下降更快。结论：东北地区MSM人群HIV-1 CRF01_AE原发感染以R5病毒感染和早期R5向X4/DM共受体转换为特征，与CD4(+) t细胞快速下降有关。研究结果强调了对感染crf01_ae的男男性行为者进行即时治疗的重要性。版权所有2018威科集团有限公司版权所有。

Objective: CRF01_AE is the most prevalent HIV-1 subtype among MSM in China. However, the characteristics and underlying mechanism of the accelerated CD4(+) T-cell decline in CRF01_AE-infected MSM remain incompletely understood.Design: A long-term prospective follow-up study was conducted with 1388 MSM at risk of HIV-1 infection in Northeast China. MSM with primary HIV-1 CRF01_AE infection were identified and followed for 3-6 years to explore the determinants of rapid CD4(+) T-cell decline.Methods: Tropism was determined in primary infection by both single genome amplification-based genotypic prediction using four different algorithms and phenotypic determination using clinical isolates. Serial isolates were used to determine phenotype of coreceptor switch. Human leukocyte antigen genotypes and T-cell activation markers were determined.Results: Fifty-nine MSM primarily infected with HIV-1 CRF01_AE were discovered and recruited for the follow-up study. CCR5-utilizing (R5) viruses accounted for up to 98% of HIV-1 CRF01_AE infections in Northeast China. Survival analysis indicated 39.5% of the patients underwent coreceptor switch within 3 years after infection. After adjustment for other potential risk factors, linear mixed-effect models demonstrated patients experienced R5 to CXCR4-utilizing/dual-tropic (X4/DM) coreceptor switchwithin 3 years after infection underwent a faster CD4(+) T-cell decline compared to those without coreceptor switch.Conclusions: Primary HIV-1 CRF01_AE infection among MSM in Northeast China is characterized by R5 viral infection and early R5 to X4/DM coreceptor switch, which is associated with rapid CD4(+) T-cell decline. The findings highlight the importance of immediate treatment among the CRF01_AE-infected MSM. Copyright (C) 2018 Wolters Kluwer Health, Inc. All rights reserved.

Rapid CD4+ T-cell decline is associated with coreceptor switch among MSM primarily infected with HIV-1 CRF01_AE in Northeast China

文献摘要

被引文献

相似文献