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HIV-1 CRF01_AE subtype and HIV-1 DNA level among patients with chronic HIV-1 infection: a correlation study
Tingxia Lyu1, Yongsong Yue1, Evelyn Hsieh1,2
1Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
Insights
HIV-1 subtype CRF01_AE is associated with higher viral DNA levels in patients on antiretroviral therapy (ART). However, subtype does not predict viral DNA decay, with baseline viral DNA and CD4+ T cell counts being key factors.
Area of Science:
- Virology
- Immunology
- Infectious Diseases
Background:
- The influence of Human Immunodeficiency Virus type 1 (HIV-1) subtypes, specifically CRF01_AE versus non-CRF01_AE, on viral DNA levels during suppressive antiretroviral therapy (ART) is not well understood.
- Investigating this relationship is crucial for understanding HIV-1 persistence and treatment outcomes.
Purpose of the Study:
- To determine the correlation between HIV-1 subtypes (CRF01_AE and non-CRF01_AE) and HIV-1 DNA levels in patients receiving ART.
- To identify baseline predictors of HIV-1 DNA decay during ART.
Main Methods:
- ART-naïve patients in China were categorized into CRF01_AE and non-CRF01_AE groups.
- Peripheral blood samples were analyzed for total HIV-1 DNA levels using real-time PCR at baseline and up to 96 weeks post-ART initiation.
- Logistic regression was employed to identify predictors of low HIV-1 DNA levels at 96 weeks.
Main Results:
- Patients with the CRF01_AE subtype had higher baseline HIV-1 DNA levels (median 3.19 log10 copies/10^6 PBMCs) compared to non-CRF01_AE subtypes (median 2.95 log10 copies/10^6 PBMCs).
- After 96 weeks of ART, HIV-1 DNA levels remained significantly higher in the CRF01_AE group (median 2.63 vs. 2.39 log10 copies/10^6 PBMCs).
- No significant difference was observed in the proportion of patients achieving low, moderate, or high HIV-1 DNA levels between the subtypes. Baseline HIV-1 DNA and CD4+ T cell counts, not subtype, were independent predictors of achieving low DNA levels.
Conclusions:
- HIV-1 CRF01_AE subtype is not correlated with HIV-1 DNA reservoir decline or achieving lower viral DNA levels after ART.
- Higher baseline HIV-1 DNA levels in CRF01_AE patients warrant increased attention and surveillance during ART.
- Baseline viral DNA load and CD4+ T cell count are more critical than subtype in predicting viral DNA decay on ART.
Background:
The impact of HIV-1 subtype (CRF01_AE and non-CRF01_AE) on HIV-1 DNA levels in HIV-1 chronically infected patients with suppressive antiretroviral therapy (ART) remains poorly understood. To evaluate the correlation of HIV-1 subtype with DNA level, and identify baseline predictors of HIV-1 DNA decay.
Methods:
ART-naïve HIV-1-infected patients from two large multi-center studies in China were classified into CRF01_AE and non-CRF01_AE subtype groups. Peripheral blood samples were collected at baseline and week 12, 24, 48 and 96 after ART initiation and total HIV-1 DNA levels were quantified by real-time PCR. HIV-1 DNA levels at week 96 were categorized into high, moderate, and low levels, reflecting HIV-1 DNA ≥ 3, 2-3, ≤ 2 log10 copies/106 PBMCs, respectively, and the corresponding proportion of CRF01_AE and non-CRF01_AE subtype were compared. The baseline predictors of low HIV-1 total DNA levels (≤ 2 log10 copies/106 PBMCs) at week 96 were evaluated using a logistic regression model.
Results:
Compared to the non-CRF01_AE subtypes (n = 185), patients with CRF01_AE subtype (n = 188) harboured a higher level of HIV-1 DNA (median: 3.19 vs. 2.95 log10 copies/106 PBMCs, P < 0.001) prior to treatment. After 96 weeks of ART, HIV-1 DNA levels remained higher in the CRF01_AE subtype group (median: 2.63 vs. 2.39 log10 copies/106 PBMCs, P = 0.002). There was no significant difference in the proportion of patients achieving high (22.3% vs. 14.6%, P = 0.054), moderate (59.6% vs. 60.5%, P = 0.849) and low levels (18.1% vs 24.9%, P = 0.111) between CRF01_AE and non-CRF01_AE groups. In the multivariable analysis, baseline HIV-1 DNA level and CD4+ T cell count but not the subtype were independent risk factors for achieving HIV-1 DNA level ≤ 2 log10 copies/106 PBMCs.
Conclusion:
HIV-1 CRF01_AE subtype is neither correlated with HIV-1 DNA reservoir decline nor a prognostic factor for achieving lower HIV-1 DNA levels (≤ 2 log10 copies/106 PBMCs) after ART. However, higher HIV-1 DNA level in HIV-1 CRF01_AE patients should be aroused much attention and strengthen surveillance during ART.
