HIV Type 1 Disease Progression to AIDS and Death in a Rural Ugandan Cohort Is Primarily Dependent on Viral Load Despite Variable Subtype and T-Cell Immune Activation Levels
Loading...
Date
2015
Journal Title
Journal ISSN
Volume Title
Publisher
The Journal of infectious diseases
Abstract
Background. Untreated human immunodeficiency virus type 1 (HIV) infection is associated with persistent im mune activation, which is an independent driver of disease progression in European and United States cohorts. In
Uganda, HIV-1 subtypes A and D and recombinant AD viruses predominate and exhibit differential rates of disease
progression.
Methods. HIV-1 seroconverters (n = 156) from rural Uganda were evaluated to assess the effects of T-cell acti vation, viral load, and viral subtype on disease progression during clinical follow-up.
Results. The frequency of activated T cells was increased in HIV-1–infected Ugandans, compared with commu nity matched uninfected individuals, but did not differ significantly between viral subtypes. Higher HIV-1 load, sub type D, older age, and high T-cell activation levels were associated with faster disease progression to AIDS or death.
In a multivariate Cox regression analysis, HIV-1 load was the strongest predictor of progression, with subtype also
contributing. T-cell activation did not emerge an independent predictor of disease progression from this particular
cohort.
Conclusions. These findings suggest that the independent contribution of T-cell activation on morbidity and
mortality observed in European and North American cohorts may not be directly translated to the HIV epidemic
in East Africa. In this setting, HIV-1 load appears to be the primary determinant of disease progression.
Keywords. HIV-1; AIDS; subtype D; immune activation; PD-1; viral load.
Description
Keywords
HIV-1, AIDS, subtype D, immune activation, PD-1, viral load.
Citation
Eller, M. A., Opollo, M. S., Liu, M., Redd, A. D., Eller, L. A., Kityo, C., ... & Robb, M. L. (2015). HIV type 1 disease progression to AIDS and death in a rural Ugandan cohort is primarily dependent on viral load despite variable subtype and T-cell immune activation levels. The Journal of infectious diseases, 211(10), 1574-1584.