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AIDS. 2017 Nov 28;31(18):2541-2546. doi: 10.1097/QAD.0000000000001659.

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

Author information

1
aCentre for Geographic Medicine Research-Coast, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya bUniversity of Oxford, Headington, UK cInternational AIDS Vaccine Initiative, New York City, New York dDepartment of Epidemiology and Biostatistics, University of California, San Francisco, California, USA eProject San Francisco, Kigali, Rwanda fUganda Research Unit on AIDS, Medical Research Council/Uganda Virus Research Institute, Entebbe, Uganda gZambia Emory Research Project, Lusaka, Zambia hDesmond Tutu HIV Centre, University of Cape Town, South Africa iKenya AIDS Vaccine Initiative, Nairobi, Kenya jDepartment of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.

Abstract

OBJECTIVE:

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.

METHODS:

ARS symptoms were assessed in adults enrolling within 6 weeks after the estimated date of infection 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 enrolment, and enrolment viral load.

RESULTS:

Among 183 volunteers ascertained within 6 weeks after estimated date of infection, 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% confidence interval: 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.

CONCLUSION:

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.

PMID:
29028659
PMCID:
PMC5690309
DOI:
10.1097/QAD.0000000000001659
[Indexed for MEDLINE]
Free PMC Article

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