TY - JOUR
T1 - Plasma HIV-1 Tropism and the Risk of Short-Term Clinical Progression to AIDS or Death
AU - Casadellà, Maria
AU - Cozzi-Lepri, Alessandro
AU - Phillips, Andrew
AU - Noguera-Julian, Marc
AU - Bickel, Markus
AU - Sedlacek, Dalibor
AU - Zilmer, Kai
AU - Clotet, Bonaventura
AU - Lundgren, Jens D
AU - Paredes, Roger
AU - EuroSIDA in EuroCOORD
AU - Zaccarelli, Mauro
AU - Antinori, Andrea
AU - Acinapura, Rosa Antonietta
AU - Plazzi, Maria Maddalena
PY - 2017
Y1 - 2017
N2 - OBJECTIVE: To investigate if plasma HIV-1 tropism testing could identify subjects at higher risk for clinical progression and death in routine clinical management.DESIGN: Nested case-control study within the EuroSIDA cohort.METHODS: Cases were subjects with AIDS or who died from any cause, with a plasma sample with HIV-1 RNA >1000 copies/mL available for tropism testing 3 to 12 months prior to the event. At least 1 control matched for age, HIV-1 RNA and HCV status at the time of sampling were selected per each case. Conditional logistic regression was used to investigate exposures associated with clinical progression to AIDS or death. A linear mixed model with random intercept was used to compare CD4+T-cell slopes by HIV tropism over the 12 months following the date of sampling.RESULTS: The study included 266 subjects, 100 cases and 166 controls; one quarter had X4 HIV; 26% were ART-naïve. Baseline factors independently associated with clinical progression or death were female gender (OR = 2.13 vs. male, 95CI = 1.04, 4.36), p = 0.038), CD4+T-cell count (OR = 0.90 (95CI = 0.80, 1.00) per 100 cells/mm3 higher, p = 0.058), being on ART (OR = 2.72 vs. being off-ART (95CI = 1.15, 6.41), p = 0.022) and calendar year of sample [OR = 0.84 (95CI = 0.77, 0.91) per more recent year, p<0.001). Baseline tropism was not associated with the risk of clinical progression or death. CD4+T-cell slopes did not differ within or between tropism groups.CONCLUSIONS: The predictive role of plasma tropism determined using 454 sequencing in the context of people receiving cART with detectable VL is not helpful to identify subjects at higher risk for clinical progression to AIDS or death.
AB - OBJECTIVE: To investigate if plasma HIV-1 tropism testing could identify subjects at higher risk for clinical progression and death in routine clinical management.DESIGN: Nested case-control study within the EuroSIDA cohort.METHODS: Cases were subjects with AIDS or who died from any cause, with a plasma sample with HIV-1 RNA >1000 copies/mL available for tropism testing 3 to 12 months prior to the event. At least 1 control matched for age, HIV-1 RNA and HCV status at the time of sampling were selected per each case. Conditional logistic regression was used to investigate exposures associated with clinical progression to AIDS or death. A linear mixed model with random intercept was used to compare CD4+T-cell slopes by HIV tropism over the 12 months following the date of sampling.RESULTS: The study included 266 subjects, 100 cases and 166 controls; one quarter had X4 HIV; 26% were ART-naïve. Baseline factors independently associated with clinical progression or death were female gender (OR = 2.13 vs. male, 95CI = 1.04, 4.36), p = 0.038), CD4+T-cell count (OR = 0.90 (95CI = 0.80, 1.00) per 100 cells/mm3 higher, p = 0.058), being on ART (OR = 2.72 vs. being off-ART (95CI = 1.15, 6.41), p = 0.022) and calendar year of sample [OR = 0.84 (95CI = 0.77, 0.91) per more recent year, p<0.001). Baseline tropism was not associated with the risk of clinical progression or death. CD4+T-cell slopes did not differ within or between tropism groups.CONCLUSIONS: The predictive role of plasma tropism determined using 454 sequencing in the context of people receiving cART with detectable VL is not helpful to identify subjects at higher risk for clinical progression to AIDS or death.
KW - Acquired Immunodeficiency Syndrome
KW - Adult
KW - Anti-HIV Agents
KW - CD4 Lymphocyte Count
KW - CD4-Positive T-Lymphocytes
KW - Disease Progression
KW - Female
KW - HIV-1
KW - Humans
KW - Male
KW - Middle Aged
KW - RNA, Viral
KW - Viral Load
KW - Viral Tropism
KW - Journal Article
U2 - 10.1371/journal.pone.0166613
DO - 10.1371/journal.pone.0166613
M3 - Article
C2 - 28129343
VL - 12
SP - e0166613
JO - PLoS One
JF - PLoS One
SN - 1932-6203
IS - 1
ER -