Tarosso Leandro F, Sanabani Sabri S, Ribeiro Susan P, Sauer Mariana M, Tomiyama Helena I, Sucupira Maria C, Diaz Ricardo S, Sabino Ester C, Kalil Jorge, Kallas Esper G
1 Division of Clinical Immunology and Allergy, School of Medicine, University of São Paulo , São Paulo, Brazil .
AIDS Res Hum Retroviruses. 2014 Feb;30(2):190-4. doi: 10.1089/AID.2012.0243. Epub 2013 Sep 6.
Although it has been suggested that biological differences among HIV-1 subtypes exist, their possible influence on disease progression has not been fully revealed. In particular, the increasing emergence of recombinants stresses the need to characterize disease presentation in persons infected by these diverse HIV-1 forms. We explored this issue among 83 Brazilian subjects infected with either HIV-1 subtype B or recombinant subtype BF, all followed since incident infection in a cohort study. Viral subtypes were assigned by full length sequencing of HIV-1 genomes. We observed that the baseline measures for CD4(+) T cells and viral load did not differ between the groups. However, longitudinal analysis revealed that subtype BF was clearly associated with a faster CD4(+) T cell decline compared to infection with subtype B, in spite of a similar plasma HIV-1 load. While subtype B-infected subjects presented a loss of 3.6 CD4(+) T cells/μl per month, subtype BF-infected individuals showed a monthly decay of 6.3 CD4(+) T cells/μl (p<0.01). The time to reach 350 CD4(+) T cells/μl and the time to start antiretroviral treatment were also shorter in subtype BF-infected persons. The elucidation of an accelerated CD4(+) T cell loss associated with subtype BF suggests that this HIV-1 genetic form could be more pathogenic than subtype B.
尽管有研究表明HIV-1亚型之间存在生物学差异，但其对疾病进展的可能影响尚未完全揭示。特别是，重组病毒的不断出现凸显了对感染这些不同HIV-1形式的人群疾病表现进行特征描述的必要性。我们在一项队列研究中，对83名感染HIV-1 B亚型或重组BF亚型的巴西受试者进行了研究，这些受试者自感染后均被随访。通过对HIV-1基因组进行全长测序来确定病毒亚型。我们观察到两组之间CD4(+) T细胞和病毒载量的基线测量值没有差异。然而，纵向分析显示，尽管血浆HIV-1载量相似，但与B亚型感染相比，BF亚型与CD4(+) T细胞更快下降明显相关。B亚型感染的受试者每月CD4(+) T细胞损失3.6个/μl，而BF亚型感染的个体每月下降6.3个/μl（p<0.01）。BF亚型感染的人达到350个/μl CD4(+) T细胞的时间和开始抗逆转录病毒治疗的时间也更短。与BF亚型相关的CD4(+) T细胞加速损失的阐明表明，这种HIV-1基因形式可能比B亚型更具致病性。
