Athens University Medical School, Athens, Greece.
PLoS One. 2013 Jul 30;8(7):e71174. doi: 10.1371/journal.pone.0071174. Print 2013.
We aimed to compare rates of virologic response and CD4 changes after combination antiretroviral (cART) initiation in individuals infected with B and specific non-B HIV subtypes.
Using CASCADE data we analyzed HIV-RNA and CD4 counts for persons infected ≥1996, ≥15 years of age. We used survival and longitudinal modeling to estimate probabilities of virologic response (confirmed HIV-RNA <500 c/ml), and failure (HIV-RNA>500 c/ml at 6 months or ≥1000 c/ml following response) and CD4 increase after cART initiation.
2003 (1706 B, 142 CRF02_AG, 55 A, 53 C, 47 CRF01_AE) seroconverters were included in analysis. There was no evidence of subtype effect overall for response or failure (p = 0.075 and 0.317, respectively) although there was a suggestion that those infected with subtypes CRF01_AE and A responded sooner than those with subtype B infection [HR (95% CI):1.37 (1.01-1.86) and 1.29 (0.96-1.72), respectively]. Rates of CD4 increase were similar in all subtypes except subtype A, which tended to have lower initial, but faster long-term, increases.
Virologic and immunologic response to cART was similar across all studied subtypes but statistical power was limited by the rarity of some non-B subtypes. Current antiretroviral agents seem to have similar efficacy in subtype B and most widely encountered non-B infections in high-income countries.
我们旨在比较感染 B 型和特定非 B 型 HIV 亚型的个体在开始联合抗逆转录病毒（cART）治疗后病毒学应答和 CD4 变化的发生率。
使用 CASCADE 数据，我们分析了感染 ≥1996 年且年龄≥15 岁的个体的 HIV-RNA 和 CD4 计数。我们使用生存和纵向建模来估计病毒学应答（确认 HIV-RNA<500 c/ml）和失败（6 个月时 HIV-RNA>500 c/ml 或应答后≥1000 c/ml）以及 cART 起始后 CD4 增加的概率。
共纳入了 2003 名（1706 名 B 型、142 名 CRF02_AG、55 名 A 型、53 名 C 型、47 名 CRF01_AE）血清转换者进行分析。虽然有迹象表明感染 CRF01_AE 和 A 亚型的个体比感染 B 亚型的个体应答更快[危险比（95%CI）：1.37（1.01-1.86）和 1.29（0.96-1.72）]，但总体上没有发现亚型对应答或失败有影响（p=0.075 和 0.317）。所有亚型的 CD4 增加率相似，除了 A 亚型，该亚型初始值较低，但长期增加较快。
cART 的病毒学和免疫学应答在所有研究的亚型中相似，但由于某些非 B 亚型的罕见性，统计学效力有限。目前的抗逆转录病毒药物在高收入国家的 B 型和最常见的非 B 型感染中似乎具有相似的疗效。
