Hualu Cui1,2,3, Wenqing Geng1,2,3, Hong Sun1,2,3, Xiaoxu Han1,2,3, Minghui An1,2,3, Yongjun Jiang1,2,3, Zining Zhang1,2,3, Zhiwei Chen4, Junjie Xu1,2,3, Qinghai Hu1,2,3, Bin Zhao1,2,3, Bennan Zhou1,2,3, Hong Shang1,2,3. 1. Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital, China Medical University. 2. Key Laboratory of AIDS immunology, Chinese Academy of Medical Sciences, Shenyang. 3. Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou. 4. AIDS Institute, Department of Microbiology and Research Centre for Infection and Immunity, the University of Hong Kong, Hong Kong Special Administrative Region, China.
Abstract
OBJECTIVE: CRF01_AE is the most prevalent HIV-1 subtype among MSM in China. However, the characteristics and underlying mechanism of the accelerated CD4 T-cell decline in CRF01_AE-infected MSM remain incompletely understood. DESIGN: A long-term prospective follow-up study was conducted with 1388 MSM at risk of HIV-1 infection in Northeast China. MSM with primary HIV-1 CRF01_AE infection were identified and followed for 3-6 years to explore the determinants of rapid CD4 T-cell decline. METHODS: Tropism was determined in primary infection by both single genome amplification-based genotypic prediction using four different algorithms and phenotypic determination using clinical isolates. Serial isolates were used to determine phenotype of coreceptor switch. Human leukocyte antigen genotypes and T-cell activation markers were determined. RESULTS: Fifty-nine MSM primarily infected with HIV-1 CRF01_AE were discovered and recruited for the follow-up study. CCR5-utilizing (R5) viruses accounted for up to 98% of HIV-1 CRF01_AE infections in Northeast China. Survival analysis indicated 39.5% of the patients underwent coreceptor switch within 3 years after infection. After adjustment for other potential risk factors, linear mixed-effect models demonstrated patients experienced R5 to CXCR4-utilizing/dual-tropic (X4/DM) coreceptor switch within 3 years after infection underwent a faster CD4 T-cell decline compared to those without coreceptor switch. CONCLUSIONS: Primary HIV-1 CRF01_AE infection among MSM in Northeast China is characterized by R5 viral infection and early R5 to X4/DM coreceptor switch, which is associated with rapid CD4 T-cell decline. The findings highlight the importance of immediate treatment among the CRF01_AE-infected MSM.
OBJECTIVE: CRF01_AE is the most prevalent HIV-1 subtype among MSM in China. However, the characteristics and underlying mechanism of the accelerated CD4 T-cell decline in CRF01_AE-infected MSM remain incompletely understood. DESIGN: A long-term prospective follow-up study was conducted with 1388 MSM at risk of HIV-1 infection in Northeast China. MSM with primary HIV-1 CRF01_AE infection were identified and followed for 3-6 years to explore the determinants of rapid CD4 T-cell decline. METHODS: Tropism was determined in primary infection by both single genome amplification-based genotypic prediction using four different algorithms and phenotypic determination using clinical isolates. Serial isolates were used to determine phenotype of coreceptor switch. Human leukocyte antigen genotypes and T-cell activation markers were determined. RESULTS: Fifty-nine MSM primarily infected with HIV-1 CRF01_AE were discovered and recruited for the follow-up study. CCR5-utilizing (R5) viruses accounted for up to 98% of HIV-1 CRF01_AE infections in Northeast China. Survival analysis indicated 39.5% of the patients underwent coreceptor switch within 3 years after infection. After adjustment for other potential risk factors, linear mixed-effect models demonstrated patients experienced R5 to CXCR4-utilizing/dual-tropic (X4/DM) coreceptor switch within 3 years after infection underwent a faster CD4 T-cell decline compared to those without coreceptor switch. CONCLUSIONS:Primary HIV-1 CRF01_AE infection among MSM in Northeast China is characterized by R5 viral infection and early R5 to X4/DM coreceptor switch, which is associated with rapid CD4 T-cell decline. The findings highlight the importance of immediate treatment among the CRF01_AE-infected MSM.
Authors: Shan Hui; Fangfang Chen; Yi Li; Yan Cui; Jinhui Zhang; Ling Zhang; Yisi Yang; Yanlin Liu; Yashuang Zhao; Fan Lv Journal: Front Public Health Date: 2022-06-02
Authors: J L Guo; Y Yan; J F Zhang; J M Ji; Z J Ge; R Ge; X F Zhang; H H Wang; Z W Chen; J Y Luo Journal: Epidemiol Infect Date: 2019-01 Impact factor: 2.451