Impact of Baseline HIV-1 Tropism on Viral Response and CD4 Cell Count Gains in HIV-Infected Patients Receiving First-line Antiretroviral Therapy
Background. Viral tropism influences the natural history of human immunodeficiency type 1 (HIV-1) disease: X4 viruses are associated with faster decreases in CD4 cell count. There is scarce information about the influence of viral tropism on treatment outcomes. Methods. Baseline plasma samples from patients recruited to the ArTEN (Atazanavir/ritnoavir vs. Nevirapine on a background of Tenofovir and Emtricitabine) trial were retrospectively tested for HIV-1 tropism using the genotypic tool geno2phenoFPR=5.7%. ArTEN compared nevirapine with atazanavir-ritonavir, both along with tenofovir-emtricitabine, in drug-naïve patients. Results. Of 569 ArTEN patients, 428 completed 48 weeks of therapy; 282 of these received nevirapine and 146 of these received atazanavir-ritonavir. Overall, non-B subtypes of HIV-1 were recognized in 96 patients (22%) and X4 viruses were detected in 55 patients (14%). At baseline, patients with X4 viruses had higher plasma HIV RNA levels (5.4 vs 5.2 log copies/mL, respectively; P = .044) and lower CD4 cell counts (145 vs 188 cells/μL, respectively; P < .001) than those with R5 strains. At week 48, virologic responses were lower in patients with X4 viruses than in patients with R5 viruses (77% vs 92%, respectively; P = .009). Multivariate analysis confirmed HIV-1 tropism as an independent predictor of virologic response at week 24 (P = .012). This association was extended to week 48 (P = .007) in clade B viruses. Conversely, CD4 cell count recovery was not influenced by baseline HIV-1 tropism. Conclusions. HIV-1 tropism is an independent predictor of virologic response to first-line antiretroviral therapy. In contrast, it does not seem to influence CD4 cell count recovery. Clinical Trials Registration. NCT00389207..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2011 |
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| Erschienen: |
2011 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:204 |
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| Sprache: |
Englisch |
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| Beteiligte Personen: |
Seclén, Eduardo [VerfasserIn] |
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| Links: |
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| Themen: |
Applied sciences |
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JST100956769 |
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| 100 | 1 | |a Seclén, Eduardo |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Impact of Baseline HIV-1 Tropism on Viral Response and CD4 Cell Count Gains in HIV-Infected Patients Receiving First-line Antiretroviral Therapy |
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| 520 | |a Background. Viral tropism influences the natural history of human immunodeficiency type 1 (HIV-1) disease: X4 viruses are associated with faster decreases in CD4 cell count. There is scarce information about the influence of viral tropism on treatment outcomes. Methods. Baseline plasma samples from patients recruited to the ArTEN (Atazanavir/ritnoavir vs. Nevirapine on a background of Tenofovir and Emtricitabine) trial were retrospectively tested for HIV-1 tropism using the genotypic tool geno2phenoFPR=5.7%. ArTEN compared nevirapine with atazanavir-ritonavir, both along with tenofovir-emtricitabine, in drug-naïve patients. Results. Of 569 ArTEN patients, 428 completed 48 weeks of therapy; 282 of these received nevirapine and 146 of these received atazanavir-ritonavir. Overall, non-B subtypes of HIV-1 were recognized in 96 patients (22%) and X4 viruses were detected in 55 patients (14%). At baseline, patients with X4 viruses had higher plasma HIV RNA levels (5.4 vs 5.2 log copies/mL, respectively; P = .044) and lower CD4 cell counts (145 vs 188 cells/μL, respectively; P < .001) than those with R5 strains. At week 48, virologic responses were lower in patients with X4 viruses than in patients with R5 viruses (77% vs 92%, respectively; P = .009). Multivariate analysis confirmed HIV-1 tropism as an independent predictor of virologic response at week 24 (P = .012). This association was extended to week 48 (P = .007) in clade B viruses. Conversely, CD4 cell count recovery was not influenced by baseline HIV-1 tropism. Conclusions. HIV-1 tropism is an independent predictor of virologic response to first-line antiretroviral therapy. In contrast, it does not seem to influence CD4 cell count recovery. Clinical Trials Registration. NCT00389207. | ||
| 540 | |a Copyright © 2011 Oxford University Press on behalf of the Infectious Diseases Society of America | ||
| 650 | 4 | |a Biological sciences |x Biology |x Physiology |x Tropisms | |
| 650 | 4 | |a Biological sciences |x Biology |x Microbiology |x Microorganisms |x Viruses |x Oncogenic viruses |x Retroviridae |x Lentivirus |x Primate lentiviruses |x HIV | |
| 650 | 4 | |a Applied sciences |x Laboratory techniques |x Virus cultivation |x Viral load | |
| 650 | 4 | |a Biological sciences |x Biology |x Microbiology |x Microorganisms |x Viruses |x Oncogenic viruses |x Retroviridae |x Lentivirus |x Primate lentiviruses |x HIV |x HIV 1 | |
| 650 | 4 | |a Biological sciences |x Biology |x Microbiology |x Microorganisms |x Viruses | |
| 650 | 4 | |a Biological sciences |x Biology |x Microbiology |x Virology | |
| 650 | 4 | |a Health sciences |x Medical sciences |x Pharmaceutics |x Pharmaceutical preparations |x Medications |x Antiinfectives |x Antivirals |x Antiretrovirals | |
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| 655 | 4 | |a research-article | |
| 700 | 1 | |a Soriano, Vicente |e verfasserin |4 aut | |
| 700 | 1 | |a González, María M. |e verfasserin |4 aut | |
| 700 | 1 | |a Martín-Carbonero, Luz |e verfasserin |4 aut | |
| 700 | 1 | |a Gellermann, Holger |e verfasserin |4 aut | |
| 700 | 1 | |a Distel, Manuel |e verfasserin |4 aut | |
| 700 | 1 | |a Kadus, Werner |e verfasserin |4 aut | |
| 700 | 1 | |a Poveda, Eva |e verfasserin |4 aut | |
| 773 | 1 | 8 | |g volume:204 |g year:2011 |g number:1 |g pages:139-144 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1093/infdis/jir218 |3 Volltext |
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