HIV-1 genotype is independently associated with immunodeficiency progression among Chinese men who have sex with men: an observational cohort study
HIV-1 genotype is independently associated with immunodeficiency progression among Chinese men who have sex with men: an observational cohort study
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HIV-1 基因型与中国男男性行为者的免疫缺陷进展独立相关：一项观察性队列研究
DOI：
10.1111/hiv.12823
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发表时间：
2019-12-21
期刊：
影响因子：
3
通讯作者：
Tang, S.
中科院分区：
文献类型：
--
作者：
Liang, Y.;Han, Z.;Tang, S.
目标 中国男男性行为者 (MSM) 中的 HIV-1 遗传多样性正在增加，但 HIV-1 基因型与疾病进展的关系仍有待阐明。方法 我们收集了 2008 年 1 月至 2017 年 3 月期间中国广州 860 名 HIV-1 感染 MSM 的观察性纵向队列研究的数据。使用 Kaplan-Meier 分析和 Cox 比例风险模型来预测从 HIV-1 诊断到免疫缺陷进展（CD4 细胞计数 < 200 个细胞/μl）的时间以及调整后的风险比（aHR）。结果 与 CRF07_BC 或 CRF55_01B 感染相比，CRF01_AE 和 HIV-1 B 亚型感染与进展为免疫缺陷的患者比例较高以及免疫缺陷发生率较高相关。与CRF07_BC相比，主要HIV-1基因型从HIV-1诊断到免疫缺陷的时间存在差异，从大到小依次为：CRF07_BC（7.03年）> CRF55_01B（5.71年，P = 0.014；aHR 3.752，P = 0.0923）> CRF01_AE（5.18年，P < 0.001；aHR 4.733，P = 0.0152）。 HIV-1 基因型、病毒载量和基线 CD4 T 细胞计数是与疾病进展相关的三个自变量。结论 我们的结果证实了免疫缺陷进展率随 HIV-1 基因型的变化而变化。 HIV-1基因型对HIV流行、患者管理和预防的影响应进一步研究。
Objectives HIV-1 genetic diversity is increasing among men who have sex with men (MSM) in China, but the association of HIV-1 genotype with disease progression remains to be elucidated. Methods We collected data in an observational longitudinal cohort study of 860 HIV-1-infected MSM in Guangzhou, China between January 2008 and March 2017. Kaplan-Meier analysis and Cox proportional hazard model were used to predict the time from HIV-1 diagnosis to immunodeficiency progression (CD4 cell count < 200 cells/mu l) as well as adjusted hazard ratio (aHR). Results CRF01_AE and HIV-1 subtype B infection were associated with higher percentage of patients progressed to immunodeficiency and higher incidence of immunodeficiency than infection with CRF07_BC or CRF55_01B. Compared with CRF07_BC, the time from HIV-1 diagnosis to immunodeficiency were different among the major HIV-1 genotypes, which ranked as follows, in descending order: CRF07_BC (7.03 years) > CRF55_01B (5.71 years, P = 0.014; aHR 3.752, P = 0.0923) > CRF01_AE (5.18 years, P < 0.001; aHR 4.733, P = 0.0152). HIV-1 genotype, viral load and baseline CD4 T-cell count were three independent variables associated with disease progression. Conclusions Our results confirm differential rates of immunodeficiency progression as a function of HIV-1 genotype. The impact of HIV-1 genotype on HIV epidemics, patient management and prevention should be further investigated.