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Title: Clinical disease associated with HIV-1 subtype B' and E infection among 2104 patients in Thailand
Authors: Pauli N. Amornkul
Somsit Tansuphasawadikul
Khanchit Limpakarnjanarat
Sirirat Likanonsakul
Nancy Young
Boonchuey Eampokalap
Jaranit Kaewkungwal
Thananda Naiwatanakul
Jennifer Von Bargen
Dale J. Hu
Timothy D. Mastro
Bureau of Epidemiology
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention
Bamrasnaradura Infectious Disease Institute
HIV/AIDS Collaboration
Mahidol University
Thailand Ministry of Public Health
Keywords: Immunology and Microbiology;Medicine
Issue Date: 11-Nov-1999
Citation: AIDS. Vol.13, No.14 (1999), 1963-1969
Abstract: Background: Two HIV-1 envelope subtypes have accounted for virtually all infections in Thailand: subtype B' (Thai B), found mainly in injection drug users (IDU), and subtype E, found in over 90% of sexually infected persons and an increasing proportion of IDU in recent years. It remains unclear whether there are differences in pathogenesis associated with these HIV-1 subtypes. Methods: From November 1993 to June 1996, demographic, risk, clinical, and laboratory data were collected by enhanced surveillance from HIV-infected inpatients (≥ 14 years) at an infectious disease hospital near Bangkok. HIV-1 subtype was determined by V3-loop peptide enzyme immunoassay (EIA). Because of confounding, multivariate analyses were stratified by risk category and controlled for sex and age. Results: The infecting HIV-1 subtype was determined for 2104 (94.9%) of 2217 HIV-infected patients with complete data: 284 (13.5%) were subtype B', 1820 (86.5%) were E. Specimens from 113 (5.1%) patients were non-reactive or dually reactive on peptide EIA and were excluded. Among IDU, 199 (67.2%) had subtype B', and 97 (32.7%) had E. IDU accounted for 70.1% (199/284) of patients with subtype B' and 5.3% (97/1820) of those with E. Patients infected with HIV-1 subtypes B' or E had similar spectrums of opportunistic infections (OI), levels of immunosuppression, and in-hospital mortality rates. Of patients who did not inject drugs, more patients infected with subtype E had extrapulmonary cryptococcosis than those with subtype B' (adjusted odds ratio, 2.6; 95% confidence interval, 1.28-5.37). Conclusion: HIV-1 subtypes B' and E seem to be associated with similar degrees of immunosuppression and, with one exception, with similar OI patterns. These data do not suggest an association between HIV-1 subtype and differences in pathogenicity.
ISSN: 02699370
Appears in Collections:Scopus 1991-2000

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