Title :

Differences in acute retroviral syndrome by HIV-1 subtype in a multicentre cohort study in Africa.

Abstract :

BACKGROUND: Symptoms of acute retroviral syndrome (ARS) may be used to identify patients with acute HIV-1 infection who seek care. ARS symptoms in African adults differ by region. We assessed whether reporting of ARS was associated with HIV-1 subtype in a multicentre African cohort study representing countries with predominant HIV-1 subtypes A, C and D. METHODOLOGY: ARS symptoms were assessed in adults enrolling ≤6 weeks after the estimated date of infection (EDI) in an acute and early HIV-1 infection cohort study. HIV-1 subtype was determined by POL-genotyping. We used log-binomial regression to compare ARS symptom prevalence among those with subtype A vs. C or D, adjusting for sex, time since enrollment, and enrolment viral load. RESULTS: Among 183 volunteers ascertained ≤6 weeks after EDI, 77 (42.0%) had subtype A, 83 (45.4%) subtype C, and 23 (12.6%) subtype D infection. Individuals with subtype A were 1.40 (95% CI: 1.17, 1.68) times as likely as individuals with subtypes C or D to report any ARS symptoms; each individual symptom other than rash was also more prevalent in subtype A than in subtype C or D, with prevalence ratios ranging from 1.94 (1.40, 2.70) for headache to 4.92 (2.24, 10.78) for lymphadenopathy. CONCLUSIONS: Individuals with subtype A were significantly more likely than individuals with subtypes C or D to report any ARS symptoms. HIV-1 subtypes may help explain differences in ARS that have been observed across regions in Africa, and may impact the yield of symptom-based screening strategies for acute HIV infection detection.

Authors :

Sanders, E.J., Price, M.A., Karita, E., Kamali, A., Kilembe, W., Bekker, L.G., Lakhi, S., Inambao, M., Anzala, O., Fast, P.E., Gilmour, J., Powers, K.A.

PubMed link :

Journals :

AIDS. 2017