PDF(Pubmed)
Abstract：
The high proportion of AIDS cases and mortality rates in Guangxi underscores the urgency to investigate the influence of HIV-1 genetic diversity on disease progression in this region. Newly diagnosed HIV-1 patients were enrolled from January 2016 to December 2021, and the follow-up work and detection of CD4+T lymphocytes were carried out every six months until December 2022. Multivariate logistic regression was used to analyze the factors affecting pre-treatment CD4+T lymphocyte counts, while local weighted regression models (LOESS) and generalized estimating equation models (GEE) were conducted to assess factors influencing CD4+T Lymphocyte Recovery. Cox regression analysis was utilized to examine the impact of subtypes on survival risk. Additionally, HIV-1 env sequences were utilized for predicting CXCR4 and CCR5 receptors. The study encompassed 1867 individuals with pol sequences and 281 with env sequences. Our findings indicate that age over 30, divorced/widowed, peasant, heterosexual infection, CRF01_AE, long-term infection, and Pre-treatment Viral load >10000 copies/ml were factors associated with higher risk for pre-treatment CD4+T lymphocyte decline. Specifically, male gender, age over 30, heterosexual infection (HETs), long-term infection, CRF01_AE, and Pre-treatment CD4 T cell counts below 350/µL were identified as risk factors impeding CD4+T lymphocyte recovery. Pre-treatment CD4+T lymphocyte counts and recovery in individuals infected with CRF01_AE were lower compared to CRF07_BC and CRF55_01B. Additionally, CRF01_AE and CRF08_BC subtypes exhibited higher mortality rates than CRF07_BC, CRF55_01B, and other subtypes. Notably, CRF01_AE demonstrated the highest percentage of CXCR4 affinity ratios. This research unveils the intricate influence of HIV-1 gene diversity on CD4+T lymphocyte dynamics and clinical outcomes. It highlights the multifaceted nature of HIV infection in Guangxi, providing novel insights into subtype-specific disease progression among HIV-infected individuals in this region.
摘要：
广西的艾滋病病例和死亡率很高，这突显了研究该地区HIV-1遗传多样性对疾病进展的影响的紧迫性。2016年1月至2021年12月纳入初诊HIV-1患者，每半年进行一次随访和CD4+T淋巴细胞检测，直至2022年12月。采用多因素logistic回归分析治疗前CD4+T淋巴细胞计数的影响因素,同时采用局部加权回归模型（LOESS）和广义估计方程模型（GEE）评估影响CD4+T淋巴细胞恢复的因素。Cox回归分析用于检查亚型对生存风险的影响。此外,HIV-1env序列用于预测CXCR4和CCR5受体。该研究涵盖了1867个具有pol序列的个体和281个具有env序列的个体。我们的研究结果表明，年龄超过30岁，离婚/丧偶，农民,异性感染,CRF01_AE,长期感染,治疗前病毒载量>10000拷贝/ml是治疗前CD4+T淋巴细胞下降风险较高的相关因素。具体来说,男性,年龄超过30岁，异性感染（HET），长期感染,CRF01_AE,和治疗前CD4T细胞计数低于350/µL被确定为阻碍CD4+T淋巴细胞恢复的危险因素。与CRF07_BC和CRF55_01B相比，感染CRF01_AE的个体的治疗前CD4+T淋巴细胞计数和恢复较低。此外,CRF01_AE和CRF08_BC亚型的死亡率高于CRF07_BC，CRF55_01B,和其他亚型。值得注意的是,CRF01_AE显示最高百分比的CXCR4亲和力比。这项研究揭示了HIV-1基因多样性对CD4+T淋巴细胞动力学和临床结果的复杂影响。突出了广西艾滋病病毒感染的多面性,为该地区HIV感染者的亚型特异性疾病进展提供了新的见解。
