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Lack of evidence for changing virulence of HIV-1 in North America

Herbeck, JT and Gottlieb, GS and Li, X and Hu, Z and Detels, R and Phair, J and Rinaldo, C and Jacobson, LP and Margolick, JB and Mullins, JI (2008) Lack of evidence for changing virulence of HIV-1 in North America. PLoS ONE, 3 (2).

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Background. Several long-term cohort studies and in-vitro fitness assays have resulted in inconsistent reports on changes in HIV-1 virulence, including reports of decreasing, stable, and increasing virulence over the course of the AIDS pandemic. We tested the hypothesis of changing HIV-1 virulence by examining trends in prognostic clinical markers of disease progression from 1984 to 2005 among nearly 400 antiretroviral-naïve participants in the United States Multicenter AIDS Cohort Study (MACS), a longitudinal study of HIV infection in men who have sex with men (MSM). Methodology/Principal Findings. Because clinical AIDS endpoints could not be used (due to antiretroviral therapies and prophylaxis), three prognostic markers of disease progression were used as proxies for HIV-1 virulence: plasma viral RNA load and CD4T cell count at "set point" (between ∼9 and ∼15 months after seroconversion), and rate of CD4 cell decline within three years after seroconversion. We performed multivariate analyses of the association between these markers and seroconversion year, with covariates including MACS site, rare/ethnic group, seroconversion age, and CCR5Δ32 status. No statistically significant association was found between year of seroconversion and "set point" plasma viral load (at ∼9 months after seroconversion: slope= -0.004 log10 copies/mL/ year, p = 0.76; at ∼15 months: slope = -0.005 log10 copies/mL/year, p = 0.71), CD4 cell count after seroconversion (at ∼9 months: slope = -0.112 cells/μL/year, p = 0.22; at ∼15 months: slope = -0.047 cells/μL/year, p = 0.64), or rate of CD4 cell decline over the first three years after seroconversion (slope = -0.010 cells/ul/yr2, p = 0.88). Conclusions/Significance. The lack of significant trends from 1984 to 2005 in these prognostic markers of HIV disease progression suggests no major change in HIV-1 virulence over the AIDS pandemic in MSM in the US. © 2008 Herbeck et al.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Herbeck, JT
Gottlieb, GS
Li, X
Hu, Z
Detels, R
Phair, J
Rinaldo, CRINALDO@pitt.eduRINALDO
Jacobson, LP
Margolick, JB
Mullins, JI
ContributionContributors NameEmailPitt UsernameORCID
Date: 6 February 2008
Date Type: Publication
Journal or Publication Title: PLoS ONE
Volume: 3
Number: 2
DOI or Unique Handle: 10.1371/journal.pone.0001525
Schools and Programs: School of Public Health > Infectious Diseases and Microbiology
Refereed: Yes
PubMed ID: 18253479
Date Deposited: 18 Jul 2012 20:58
Last Modified: 22 Jun 2021 10:55


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