Plasma HIV-1 Tropism and the Risk of Short- Term Clinical Progression to AIDS or Death

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 pla...

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Detalles Bibliográficos
Autores: Casadellà, Maria, Cozzi-Lepri, Alessandro, Phillips, Andrew, Noguera-Julian, Marc, Bickel, Markus, Sedlacek, Dalibor, Zilmer, Kai, Clotet, Bonaventura, Lundgren, Jens D., Paredes, Roger
Tipo de recurso: artículo
Fecha de publicación:2017
País:España
Institución:UVic-UCC
Repositorio:RiUVic. Repositori institucional de la UVic-UCC
OAI Identifier:oai:dspace.uvic.cat:10854/4927
Acceso en línea:http://hdl.handle.net/10854/4927
https://doi.org/10.1371/journal.pone.0166613
Access Level:acceso abierto
Palabra clave:Sida -- Tractament
VIH (Virus)
Descripción
Sumario: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.