Increased HIV-1 superinfection risk in carriers of specific human leukocyte antigen alleles.
AIDS
; 31(8): 1149-1158, 2017 05 15.
Article
en En
| MEDLINE
| ID: mdl-28244954
ABSTRACT
OBJECTIVE:
The aim of this study was to characterize the demographic, behavioural, clinical and immunogenetic determinants of HIV-1 superinfection in a high-risk cohort of MSM.DESIGN:
A retrospective cohort study of prospectively followed MSM.METHODS:
Ninety-eight MSM with acute or early HIV-1 monoinfection were followed for a median of 15.6 months. Demographic and human leukocyte antigen (HLA) genotype data were collected at enrolment. Sexual behaviour, clinical and the infection status (monoinfection or superinfection) data were recorded at each visit (at enrolment and thereafter at a median of 4.2-month intervals). HIV-1 superinfection risk was determined by Cox regression and Kaplan-Meier survival analysis.RESULTS:
Ten individuals (10.2%) had superinfection during follow-up. Cox regression did not show significantly increased superinfection risk for individuals with an increased amount of condomless anal intercourse, lower CD4 T-cell count or higher viral load, but higher number of sexual contacts demonstrated a trend towards significance [hazard ratio, 4.74; 95% confidence interval (95% CI), 0.87-25.97; Pâ=â0.073]. HLA-A*29 (hazard ratio, 4.10; 95% CI, 0.88-14.76; Pâ=â0.069), HLA-B*35 (hazard ratio, 4.64; 95% CI, 1.33-18.17; Pâ=â0.017), HLA-C*04 (hazard ratio, 5.30; 95% CI, 1.51-20.77; Pâ=â0.010), HLA-C*16 (hazard ratio, 4.05; 95% CI, 0.87-14.62; Pâ=â0.071), HLA-DRB1*07 (hazard ratio, 3.29; 95% CI, 0.94-12.90; Pâ=â0.062) and HLA-DRB1*08 (hazard ratio, 15.37; 95% CI, 2.11-79.80; Pâ=â0.011) were associated with an increased risk of superinfection at αâ=â0.10, whereas HLA-DRB1*11 was associated with decreased superinfection risk (hazard ratio, 0.13; 95% CI, 0.00-1.03; Pâ=â0.054).CONCLUSION:
HLA genes may, in part, elucidate the genetic basis of differential superinfection risk, and provide important information for the development of efficient prevention and treatment strategies of HIV-1 superinfection.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Sobreinfección
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Infecciones por VIH
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Alelos
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Antígenos HLA
Tipo de estudio:
Etiology_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Límite:
Adult
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Humans
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Male
/
Middle aged
Idioma:
En
Revista:
AIDS
Asunto de la revista:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Año:
2017
Tipo del documento:
Article
País de afiliación:
Estados Unidos