School of Medicine, University of Maryland, Baltimore.
School of Medicine, Temple University, Philadelphia, Pennsylvania.
Clin Infect Dis. 2018 Apr 17;66(9):1448-1453. doi: 10.1093/cid/cix1019.
Human immunodeficiency virus type 1 (HIV-1) subtype has been shown to be associated with disease progression. We compared cognitive function between individuals infected with HIV-1 subtype G and CRF02_AG in Nigeria.
For this cross-sectional study, samples were analyzed from 146 antiretroviral-naive participants. Genotypic analysis of plasma HIV RNA was performed by nested polymerase chain reaction of protease and reverse transcriptase genes, and sequences were aligned with curated HIV-1 subtype references. Cognitive status was determined using demographically adjusted T scores and global deficit score (GDS) obtained from a comprehensive neuropsychological test battery.
A total of 76 (52.1%) participants were infected with CRF02_AG, 48 (32.8%) with subtype G, and 22 (15.1%) with other HIV-1 strains. In a multivariable linear regression adjusting for plasma HIV RNA, CD4 count, and depression score, mean global T score was lower among subtype G-infected compared with CRF02_AG-infected participants (mean difference, -3.0 [95% confidence interval {CI}, -5.2, to -.7]; P = .011). Also, T scores were significantly lower among subtype G- than CRF02_AG-infected participants for the speed of information processing, executive function, and verbal fluency ability domains. Adjusting for similar variables in a logistic regression, the odds of global cognitive impairment (GDS ≥0.5) were 2.2 times higher among subtype G compared with CRF02_AG-infected participants (odds ratio, 2.2 [95% CI, .9-5.4]; P = .078).
Cognitive performance was significantly worse among antiretroviral-naive individuals with HIV-1 subtype G vs CRF02_AG infection. Further studies are required to characterize the mechanistic basis for these differences.
已证实人类免疫缺陷病毒 1 型（HIV-1）亚型与疾病进展有关。我们比较了在尼日利亚感染 HIV-1 亚型 G 和 CRF02_AG 的个体之间的认知功能。
在这项横断面研究中，分析了 146 名未接受抗逆转录病毒治疗的参与者的样本。通过巢式聚合酶链反应对血浆 HIV RNA 进行基因分型分析，对蛋白酶和逆转录酶基因进行分析，并将序列与经过精心整理的 HIV-1 亚型参考序列进行比对。使用来自综合神经心理学测试组合的经过人口统计学调整的 T 分数和总体缺陷分数（GDS）来确定认知状态。
共有 76 名（52.1%）参与者感染了 CRF02_AG，48 名（32.8%）感染了亚型 G，22 名（15.1%）感染了其他 HIV-1 株。在调整血浆 HIV RNA、CD4 计数和抑郁评分的多变量线性回归中，与 CRF02_AG 感染相比，G 亚型感染的参与者的平均总体 T 评分较低（平均差异，-3.0 [95%置信区间 {CI}，-5.2，-0.7]；P =.011）。此外，与 CRF02_AG 感染相比，G 亚型感染的参与者在信息处理速度、执行功能和言语流畅性能力领域的 T 评分显著较低。在逻辑回归中调整类似的变量，与 CRF02_AG 感染相比，G 亚型感染的参与者发生总体认知障碍（GDS≥0.5）的几率高 2.2 倍（比值比，2.2 [95% CI，0.9-5.4]；P =.078）。
与感染 CRF02_AG 的个体相比，未接受抗逆转录病毒治疗的个体中 HIV-1 亚型 G 的认知表现明显更差。需要进一步的研究来描述这些差异的机制基础。
