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
PY - 2017/1
Y1 - 2017/1
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.
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.
KW - Acquired Immunodeficiency Syndrome/blood
KW - Adult
KW - Anti-HIV Agents/therapeutic use
KW - CD4 Lymphocyte Count
KW - CD4-Positive T-Lymphocytes/virology
KW - Disease Progression
KW - Female
KW - HIV-1/genetics
KW - Humans
KW - Male
KW - Middle Aged
KW - RNA, Viral/blood
KW - Viral Load/genetics
KW - Viral Tropism/genetics
U2 - 10.1371/journal.pone.0166613
DO - 10.1371/journal.pone.0166613
M3 - Journal article
C2 - 28129343
SN - 1932-6203
VL - 12
JO - PLoS Computational Biology
JF - PLoS Computational Biology
IS - 1
M1 - e0166613
ER -
