HIV-1 Subtypes and treatment outcome among adults on Antiretroviral therapy at tertiary hospital in Moshi, Tanzania

  • Elichilia R Shao Department of Internal Medicine Kilimanjaro Christian Medical University College P.O. Box 3010 Moshi, Tanzania
  • Emmanuel G Kifaro Department of Internal Medicine Kilimanjaro Christian Medical University College P.O. Box 3010 Moshi, Tanzania
  • Janet Sabuni
  • John G Mrema
  • Johnstone Kayandababila
  • Balthazar N Nyombi
Keywords: HIV-1 diversity, immunological failure, ELISA, Peptides and immunodominant region.

Abstract

Background: Human Immunodeficiency virus (HIV) is characterized by great genetic diversity due to its high mutations that occur during replication. Its infection also characterized by high rates of viral turnover and extensive viral diversity. This diverse has implication on disease progression, diagnostic strategies, vaccine development as well as treatment response to antiretroviral drugs.

Methods:  63 HIV positive adults infected by different HIV-1 Subtypes at Kilimanjaro Christian Medical Centre (KCMC) in Moshi, Tanzania were studied. HIV-1 Subtypes were characterized using peptide ELISA representing HIV-1 subtypes A, B, C, D and E derived from consensus gp 120 V3 sequences. The CD4+T-lymphocyte cell counts were measured at baseline, six and twelve months using FACS Calliber (Becton Dickinson, San Jose, CA, USA).

Results: HIV-1 Subtype A was the most prevalent (47.62%), followed by Subtype C (36.51%) and Subtype D (15.87%). Subtype D showed higher immunological and clinical failures as compared to subtype A and C with Hazard Ratio (H.R, 5.6) and 95% CI=1.3-5.2, P=0.02). After adjustment for sex, baseline CD4+ T Lymphocyte and clinical stage, the association remained the same.

Conclusions: HIV-1 A was the most predominant followed by C and D was less predominant. HIV-1 D showed rapid progression of diseases with poor treatment outcomes relative to others subtypes.

References

Bartlett, J. A., DeMasi, R., Quinn, J., Moxham, C., & Rousseau, F. 2001, "Overview of the effectiveness of triple combination therapy in antiretroviral-naive HIV-1 infected adults", AIDS, vol. 15, no. 11, pp. 1369-1377.

Buonaguro, L., Tagliamonte, M., Tornesello, M. L., & Buonaguro, F. M. 2007, "Genetic and phylogenetic evolution of HIV-1 in a low subtype heterogeneity epidemic: the Italian example", Retrovirology., vol. 4, p. 34.

Cohen, M. S., Hellmann, N., Levy, J. A., DeCock, K., & Lange, J. 2008, "The spread, treatment, and prevention of HIV-1: evolution of a global pandemic", J.Clin.Invest, vol. 118, no. 4, pp. 1244-1254.

Easterbrook, P. J., Smith, M., Mullen, J., O'Shea, S., Chrystie, I., de, R. A., Tatt, I. D., Geretti, A. M., & Zuckerman, M. 2010, "Impact of HIV-1 viral subtype on disease progression and response to antiretroviral therapy", J.Int.AIDS Soc., vol. 13, p. 4.

Geretti, A. M. 2006, "HIV-1 subtypes: epidemiology and significance for HIV management", Curr.Opin.Infect.Dis., vol. 19, no. 1, pp. 1-7.

Geretti, A. M., Harrison, L., Green, H., Sabin, C., Hill, T., Fearnhill, E., Pillay, D., & Dunn, D. 2009, "Effect of HIV-1 subtype on virologic and immunologic response to starting highly active antiretroviral therapy", Clin.Infect.Dis., vol. 48, no. 9, pp. 1296-1305.

Hosseinipour, M. C., van Oosterhout, J. J., Weigel, R., Phiri, S., Kamwendo, D., Parkin, N., Fiscus, S. A., Nelson, J. A., Eron, J. J., & Kumwenda, J. 2009, "The public health approach to identify antiretroviral therapy failure: high-level nucleoside reverse transcriptase inhibitor resistance among Malawians failing first-line antiretroviral therapy", AIDS, vol. 23, no. 9, pp. 1127-1134.

J Ananworanich Genital shedding of HIV after scheduled treatment interruption 2011.

Jacobs, G. B., Loxton, A. G., Laten, A., Robson, B., van Rensburg, E. J., & Engelbrecht, S. 2009, "Emergence and diversity of different HIV-1 subtypes in South Africa, 2000-2001", J.Med.Virol., vol. 81, no. 11, pp. 1852-1859.

Johannessen, A., Naman, E., Kivuyo, S. L., Kasubi, M. J., Holberg-Petersen, M., Matee, M. I., Gundersen, S. G., & Bruun, J. N. 2009, "Virological efficacy and emergence of drug resistance in adults on antiretroviral treatment in rural Tanzania", BMC.Infect.Dis., vol. 9, p. 108.

Kiwelu, I. E., Koulinska, I. N., Nkya, W. M., Shao, J., Kapiga, S., & Essex, M. 2005, "Identification of CRF10_CD viruses among bar and hotel workers in Moshi, Northern Tanzania", AIDS Res.Hum.Retroviruses, vol. 21, no. 10, pp. 897-900.

McCutchan, F. E. 2000, "Understanding the genetic diversity of HIV-1", AIDS, vol. 14 Suppl 3, p. S31-S44.

Mellows R J 1997 “plasma viral load CD4+lymphocytes as a prognostic markers of HIV-1 infection

Nyombi, B. M., Kristiansen, K. I., Bjune, G., Muller, F., & Holm-Hansen, C. 2008a, "Diversity of human immunodeficiency virus type 1 subtypes in Kagera and Kilimanjaro regions, Tanzania", AIDS Res.Hum.Retroviruses, vol. 24, no. 6, pp. 761-769.

Nyombi, B. M., Nkya, W., Barongo, L., Bjune, G., Kristiansen, K. I., Muller, F., & Holm-Hansen, C. 2008b, "Evolution of human immunodeficiency virus type 1 serotypes in northern Tanzania: a retrospective study", APMIS, vol. 116, no. 6, pp. 507-514.

Robertson, D. L., Anderson, J. P., Bradac, J. A., Carr, J. K., Foley, B., Funkhouser, R. K., Gao, F., Hahn, B. H., Kalish, M. L., Kuiken, C., Learn, G. H., Leitner, T., McCutchan, F., Osmanov, S., Peeters, M., Pieniazek, D., Salminen, M., Sharp, P. M., Wolinsky, S., & Korber, B. 2000, "HIV-1 nomenclature proposal", Science, vol. 288, no. 5463, pp. 55-56.

UNAIDS progress report on global HIV/AIDS response 2011

Vladimir N. Extended high viremics: a substantial fraction of individuals maintain high plasma viral RNA levels after acute HIV-1 subtype C infection 2009.

Wirden, M., Simon, A., Schneider, L., Tubiana, R., Malet, I., it-Mohand, H., Peytavin, G., Katlama, C., Calvez, V., & Marcelin, A. G. 2009, "Raltegravir has no residual antiviral activity in vivo against HIV-1 with resistance-associated mutations to this drug", J.Antimicrob.Chemother., vol. 64, no. 5, pp. 1087-1090.

World Health Organization, Epidemic update and health sector progress towards Universal Access Progress Report 2011.

Published
2017-04-01
Section
Original Research