HIV-1 Subtypes and Response to Combination Antiretroviral Therapy in Europe

Antiviral Therapy - Tập 11 Số 6 - Trang 707-716 - 2006
Wendy Bannister1, Lı́dia Ruiz2, Clive Loveday3, Stefano Vella4, Kai Zilmer5, Jesper Kjær6, Brygida Knysz7, Andrew Carr8, Amanda Mocroft8, Jens Lundgren6
1Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, UK. [email protected]
2Hospital Universitari Germans Trias i Pujol, Badalona, Spain
3ICVC-International Clinical Virology Centre, Buckinghamshire, UK
4Instituto Superiore di Sanita´, Rome Italy
5West-Tallinn Central Hospital, Tallinn, Estonia
6Copenhagen HIV Programme, Hvidovre Hospital, Copenhagen, Denmark
7Medical University, Wroclaw, Poland
8Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, UK

Tóm tắt

Background Combination antiretroviral therapy (cART) may vary in ability to suppress viral load and increase CD4+ T-cell count in people infected with different HIV-1 subtypes, possibly due to differences in resistance development. Antiretroviral drugs have predominantly been developed in Western Europe/North America on the basis of the most prevalent subtype, B. However, non-B subtypes are increasingly spreading worldwide. Objective To compare virological and immunological response to cART between patients infected with B and non-B subtypes across Europe. Design EuroSIDA prospective, observational cohort with 11,928 HIV-1-infected patients. Methods Response to cART was analysed in patients with subtypes determined pre-cART, via multivariable logistic regression on the first measurements 6–12 months after starting cART. A virological response was defined as a viral load <500 copies/ml and immunological response as a CD4+ T-cell count increase of ≥100 cells/mm3. Results Forty-five percent of patients were antiretroviral naive at initiation of cART. Virological suppression was achieved by 58% of 689 subtype-B-infected patients and 66% of 102 non-B-infected patients ( P=0.159). After adjustment for potential confounders, there was no significant difference in odds of achieving virological suppression (non-B compared with B; odds ratio [OR]: 1.05, 95% confidence interval [CI]: 0.58–1.93, P=0.866). An immunological response was achieved by 43% of 753 B-infected patients and 48% of 114 non-B-infected patients ( P=0.334). After adjustment, there was no significant difference in odds of an immunological response (OR: 1.17, 95% CI: 0.73–1.87, P=0.524). Conclusions There was no evidence of significant differences in virological or immunological response to cART between patients infected with HIV-1 B and non-B subtypes.

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Antiviral Therapy

Tập 11 Số 6

707-716

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