Hospital Ramón y Cajal, Madrid, Spain.
HIV Clin Trials. 2009 Nov-Dec;10(6):394-402. doi: 10.1310/hct1006-394.
To determine the prevalence of CCR5-tropic HIV-1 among treatment-experienced patients in Spain.
Epidemiologic, cross-sectional, and non-interventional study between January and June 2008 in HIV-1-infected patients in Spain.
A total of 485 treatment-experienced patients from across Spainand with a plasma viral load of not greater-than1000 copies/mL were studied. Viral tropism, CD4+ cell count, plasma viral load, stage of disease, and current treatment strategies were determined. Univariate and multivariate logistic regression analyses were used to determine association of coreceptor use with patients' characteristics.
Coreceptor usage was determined by viral tropism assays: 290 (68.9%) patients had CCR5-tropic HIV-1 virus, and 131 (31.1%) had dual-tropic/mixed or CXCR4 virus variants. Mean CD4+ cell counts in the R5 group (319.4 cells/mm3) were higher than in the non-R5 group (237.9 cells/mm3) (p = .0005). There was an inverse relationship between CD4+ cell counts and plasma viral load, but regression analyses on covariates associated with CCR5 tropism showed that only a higher CD4+ cell number was significantly associated with CCR5 coreceptor usage.
The prevalence of CCR5-tropic HIV-1 among treatment-experienced patients in Spain is higher than previously found in other geographical settings. We did not find independent markers predictive of coreceptor usage other than a relationship with CD4+ levels.
确定西班牙接受过治疗的患者中CCR5嗜性HIV-1的流行率。
2008年1月至6月间在西班牙对HIV-1感染患者进行的流行病学、横断面和非干预性研究。
共研究了485名来自西班牙各地、血浆病毒载量不超过1000拷贝/毫升且接受过治疗的患者。测定病毒嗜性、CD4+细胞计数、血浆病毒载量、疾病阶段和当前治疗策略。采用单变量和多变量逻辑回归分析来确定共受体使用与患者特征之间的关联。
通过病毒嗜性检测确定共受体使用情况：290名（68.9%）患者感染CCR5嗜性HIV-1病毒，131名（31.1%）患者感染双嗜性/混合或CXCR4病毒变体。R5组的平均CD4+细胞计数（319.4个细胞/立方毫米）高于非R5组（237.9个细胞/立方毫米）（p = 0.0005）。CD4+细胞计数与血浆病毒载量呈负相关，但对与CCR5嗜性相关的协变量进行回归分析显示，只有较高的CD4+细胞数量与CCR5共受体使用显著相关。
西班牙接受过治疗的患者中CCR5嗜性HIV-1的流行率高于此前在其他地区的发现。除了与CD4+水平的关系外，我们未发现预测共受体使用的独立标志物。
