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J Infect Dis. 2011 Feb 15;203(4):442-51. doi: 10.1093/infdis/jiq085. Epub 2011 Jan 18.

Sex, race, and geographic region influence clinical outcomes following primary HIV-1 infection.

Author information

  • 1Department of Medicine, University of Colorado Denver, Aurora, CO 80045, USA. amie.meditz@ucdenver.edu

Abstract

BACKGROUND:

It is unknown whether sex and race influence clinical outcomes following primary human immunodeficiency virus type 1 (HIV-1) infection.

METHODS:

Data were evaluated from an observational, multicenter, primarily North American cohort of HIV-1 seroconverters.

RESULTS:

Of 2277 seroconverters, 5.4% were women. At enrollment, women averaged .40 log₁₀ fewer copies/mL of HIV-1 RNA (P < .001) and 66 more CD4(+) T cells/μL (P = .006) than men, controlling for age and race. Antiretroviral therapy (ART) was less likely to be initiated at any time point by nonwhite women and men compared to white men (P < .005), and by individuals from the southern United States compared to others (P = .047). Sex and race did not affect responses to ART after 6 months (P > .73). Women were 2.17-fold more likely than men to experience >1 HIV/AIDS-related event (P < .001). Nonwhite women were most likely to experience an HIV/AIDS-related event compared to all others (P = .035), after adjusting for intravenous drug use and ART. Eight years after diagnosis, >1 HIV/AIDS-related event had occurred in 78% of nonwhites and 37% of whites from the southern United States, and 24% of whites and 17% of nonwhites from other regions (P < .001).

CONCLUSIONS:

Despite more favorable clinical parameters initially, female HIV-1-seroconverters had worse outcomes than did male seroconverters. Elevated morbidity was associated with being nonwhite and residing in the southern United States.

Comment in

PMID:
21245157
[PubMed - indexed for MEDLINE]
PMCID:
PMC3071223
Free PMC Article

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