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PLoS One. 2013 Nov 27;8(11):e81213. doi: 10.1371/journal.pone.0081213. eCollection 2013.

Association of pol diversity with antiretroviral treatment outcomes among HIV-infected African children.

Author information

1
Dept. of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America.

Erratum in

  • PLoS One. 2013;8(12):doi/10.1371/annotation/6937ccda-2f54-430d-94d0-b71d1ecc5273.
  • PLoS One. 2013;8(12): doi/10.1371/annotation/dd945f7c-c50b-461d-ab38-15e8b0966458.

Abstract

BACKGROUND:

In HIV-infected children, viral diversity tends to increase with age in the absence of antiretroviral treatment (ART). We measured HIV diversity in African children (ages 6-36 months) enrolled in a randomized clinical trial comparing two ART regimens (Cohort I of the P1060 trial). Children in this cohort were exposed to single dose nevirapine (sdNVP) at birth.

METHODS:

HIV diversity was measured retrospectively using a high resolution melting (HRM) diversity assay. Samples were obtained from 139 children at the enrollment visit prior to ART initiation. Six regions of the HIV genome were analyzed: two in gag, one in pol, and three in env. A single numeric HRM score that reflects HIV diversity was generated for each region; composite HRM scores were also calculated (mean and median for all six regions).

RESULTS:

In multivariable median regression models using backwards selection that started with demographic and clinical variables, older age was associated with higher HRM scores (higher HIV diversity) in pol (P = 0.005) and with higher mean (P = 0.014) and median (P<0.001) HRM scores. In multivariable models adjusted for age, pre-treatment HIV viral load, pre-treatment CD4%, and randomized treatment regimen, higher HRM scores in pol were associated with shorter time to virologic suppression (P = 0.016) and longer time to study endpoints (virologic failure [VF], VF/death, and VF/off study treatment; P<0.001 for all measures).

CONCLUSIONS:

In this cohort of sdNVP-exposed, ART-naïve African children, higher levels of HIV diversity in the HIV pol region prior to ART initiation were associated with better treatment outcomes.

PMID:
24312277
PMCID:
PMC3842253
DOI:
10.1371/journal.pone.0081213
[Indexed for MEDLINE]
Free PMC Article

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