Jen I-An, Li Wei-You, Wu Shang-Jung, Chen Patricia M T, Liu Wei-Lun, Yen Yung-Feng, Fann Cathy Shen Jang, Chen Yi-Ming Arthur
Institute of Brain Science, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
Department and Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
PLoS One. 2025 Jun 3;20(6):e0323250. doi: 10.1371/journal.pone.0323250. eCollection 2025.
Previously, we reported that HIV-1 patients infected with CRF07_BC had significantly lower viral loads than those infected with subtype B. Since HIV-1 viral load is associated with AIDS disease progression, the current study was to link multiple clinical and molecular databases, and compare clinical outcomes of HIV-1patients infected with CRF07_BC, CRF01_AE and subtype B in Taiwan. Molecular genotyping data of 2,982 HIV-1/AIDS patients were submitted to Taiwan CDC HIV-1/AIDS case management database. Then the database was linked to Taiwan National Health Insurance Research database and National Cause of Death database from 2000-2016. Subsequently, a subtype-based HIV/AIDS clinical database containing 1,605 patients including 858 (53.5%) subtype B, 690 (43.0%) CRF07_BC and 57 (3.5%) CRF01_AE patients was successfully established and the clinical outcomes and survival of these patients were analyzed. Analysis of transmission route showed this HIV-1/AIDS cohort consists of 761 (47.4%) men who have sex with men (MSM), 132 (8.2%) heterosexuals and 712 (44.4%) injection drug user (IDUs). Survival analysis showed subtype B patients had a significantly lower death rate (8.2%) than CRF07_BC and CRF01-AE patients (22.8% and 22.8%, respectively). The higher death rate for CRF07_BC versus subtype B patients could be largely influenced by transmission route (IDU: 95.7% vs. 3.9%; MSM: 85.8% vs. 2.0%), as well as lower ART uptake rates (69.9% vs. 96.3%). Indeed, subset analysis among IDU patients, CRF07_BC-infected patients had a better 16-year survival rate than patients infected with subtype B (74.3% vs. 45.7%, p < 0.05). Our findings suggest that the transmission route is one major factor influencing death rate, while ART treatment and HIV-1 subtypes may also play important roles. Our study is the largest long-term cohort study of patients infected with CRF07_BC and subtype B in the same geographic region.
此前，我们报道过感染CRF07_BC的HIV-1患者的病毒载量显著低于感染B亚型的患者。由于HIV-1病毒载量与艾滋病疾病进展相关，当前研究旨在关联多个临床和分子数据库，并比较台湾地区感染CRF07_BC、CRF01_AE和B亚型的HIV-1患者的临床结局。2982例HIV-1/AIDS患者的分子基因分型数据被提交至台湾疾病管制署的HIV-1/AIDS病例管理数据库。然后该数据库与2000年至2016年的台湾全民健康保险研究数据库和国家死因数据库相链接。随后，成功建立了一个基于亚型的HIV/AIDS临床数据库，其中包含1605例患者，包括858例（53.5%）B亚型、690例（43.0%）CRF07_BC和57例（3.5%）CRF01_AE患者，并对这些患者的临床结局和生存情况进行了分析。传播途径分析显示，这个HIV-1/AIDS队列包括761例（47.4%）男男性行为者（MSM）、132例（8.2%）异性恋者和712例（44.4%）注射吸毒者（IDU）。生存分析显示，B亚型患者的死亡率（8.2%）显著低于CRF07_BC和CRF01-AE患者（分别为22.8%和22.8%）。CRF07_BC患者相对于B亚型患者的较高死亡率可能在很大程度上受到传播途径（IDU：95.7%对3.9%；MSM：85.8%对2.0%）以及较低的抗逆转录病毒治疗使用率（69.9%对96.3%）的影响。事实上，在IDU患者的亚组分析中，感染CRF07_BC的患者16年生存率高于感染B亚型的患者（74.3%对45.7%，p<0.05）。我们的研究结果表明，传播途径是影响死亡率的一个主要因素，而抗逆转录病毒治疗和HIV-1亚型也可能发挥重要作用。我们的研究是同一地理区域内感染CRF07_BC和B亚型患者的最大规模长期队列研究。
