HIV-1 tropism and CD4 T lymphocyte recovery in a prospective cohort of patients initiating HAART in Ribeirão Preto, Brazil

Author(s)

Lanca, Andre Minhoto ^[1] ; Baima Collares, Jeova Keny ^[2] ; de Paula Ferreira, Joao Leandro ^[1] ; Lima, Danielle Malta ^[2] ; de Macedo Brigido, Luis Fernando ^[1] ; Rodrigues, Rosangela ^[1] ; Lopes da Fonseca, Benedito Antonio ^[3]

Affiliation

^[1] Adolfo Lutz Inst, Lab Retrovirus, Ctr Virol, Sao Paulo - Brazil

^[2] Univ Fortaleza, Fortaleza, Ceara - Brazil

^[3] Univ Sao Paulo, Ctr Pesquisa Virol, Fac Med, BR-14049 Ribeirao Preto, SP - Brazil

• Document type: Journal article
• Source: Memórias do Instituto Oswaldo Cruz; v. 107, n. 1, p. 96-101, FEB 2012.
• Web of Science Citations: 6

Abstract

While human immunodeficiency virus (HIV)-1 chemokine co-receptors 5 tropism and the GWGR motif in the envelope third variable region (V3 loop) have been associated with a slower disease progression, their influence on antiretroviral response remains unclear. The impact of baseline V3 characteristics on treatment response was evaluated in a randomised, double blind, prospective cohort study with patients initiating highly active antiretroviral therapy with lopinavir or efavirenz plus azithothymidine/3TC (1:1) over 48 weeks. Similar virological and immunological responses were observed for both treatment regimens. The 43 individuals had a mean baseline CD4 T cell count of 119 cells/mm³ [standard deviation (SD) = 99] and a mean viral load of 5.09 log10 copies/mL (SD = 0.49). The GWGR motif was not associated with a CD4 T cell response, but predicted R5 tropism by the geno2pheno[clinical20%] algorithm correlated with higher CD4 T cell levels at all monitoring points (p < 0.05). Moreover, higher false-positive rates (FPR) values from this analysis revealed a strong correlation with CD4 T cell recovery (p < 0.0001). Transmitted drug resistance mutations, documented in 3/41 (7.3%) cases, were unrelated to the assigned antiretroviral regimen and had no impact on patient outcomes. In conclusion, naÏve HIV-1 R5 infected patients exhibited higher CD4 T cell counts at baseline; this difference was sustained throughout therapy. The geno2pheno[clinical] option FPR positively correlated with CD4 T cell gain and may be useful in predicting CD4 T cell recovery. (AU)

• FAPESP's process: 06/61311-0 - HIV genotyping test and of salvage therapies in the state of São Paulo
• Grantee: Rosangela Rodrigues
• Support Opportunities: Research Grants - Research in Public Policies for the National Health Care System (PP-SUS)