[afro-nets] Type of AIDS Infection Key to Death Risk - Study

[Claudio Schuftan <claudio@hcmc.netnam.vn>]

Type of AIDS Infection Key to Death Risk - Study
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UGANDA; UNITED STATES: Reuters (02.06.06): Maggie Fox

The clade, or subtype, of HIV infection was a better predictor
of rapid AIDS mortality than viral load in a Ugandan study re-
cently presented at the 13th Conference on Retroviruses and Op-
portunistic Infections in Denver. Conducted by US and Ugandan
researchers, the study found that people infected with clade D
HIV died more quickly than those infected with clade A virus.

HIV has mutated into nine clades that roughly correspond to geo-
graphical boundaries. Clades A and D are found in Uganda, while
clade C is common in Botswana, South Africa, India and parts of
China. Clade B is prevalent in Europe and the United States.

Researchers studied 300 men and women newly infected with HIV
between 1995 and 2001 in Rakai, Uganda. Of those infected, 53
had clade A HIV, 203 had clade D, and 70 were infected with a
mixed A-D clade.

Of those infected with clade D virus, 10 percent died within
three years, and none of those with clade A died so quickly, the
study found. People with clade A lived an average 8.8 years,
compared to just 6.9 years for people with clade D virus and 5.8
years for those with A-D clade.

"Knowing a person's HIV subtype is important for the management
of the infection because the disease can progress more rapidly
in those infected with subtype D. than in those with other sub-
types," said Olivier Laeyendecker, a senior research associate
with Johns Hopkins University (JHU) School of Medicine who led
the investigation. For those HIV patients with medical care, DNA
testing to determine clade may be an important aspect of that
care, researchers said.

The JHU team said clade D may be more virulent because 25 per-
cent of D virus uses multiple receptors, CCR5 and CXCR4, to in-
fect T cells while clade A uses just CCR5. Of those whose virus
used CXCR4, two-thirds died within three years, said research-
ers.