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BMC Infectious Diseases
Published in: BMC Infectious Diseases 1/2013

Open Access 01-12-2013 | Research article

X4 viruses are frequently archived in patients with long-term HIV infection but do not seem to influence the “inflamm-aging” process

Authors: Annalisa Saracino, Laura Monno, Luigia Scudeller, Giuseppe Bruno, Nicoletta Ladisa, Grazia Punzi, Anna Volpe, Antonella Lagioia, Gioacchino Angarano

Published in: BMC Infectious Diseases | Issue 1/2013

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Abstract

Background

Co-receptor tropism (CRT) in patients with a long history of HIV-1 infection and antiretroviral treatment has been rarely investigated to date. The aim of this study was to determine the prevalence of X4 and R5 strains in patients with a >15-year follow-up and to investigate the demographical, viral, immunological, clinical and therapeutic determinants of CRT in this population. The possible influence of CRT on the inflammation state related to chronic HIV infection was also examined.

Methods

A total of 118 HIV-1 infected patients with an initial HIV-1-positive test before 1997, and still on follow-up, were enrolled and consecutively submitted to blood sampling. Of these, 111 were on antiretroviral therapy and 89/111 (80.2%) had a plasma viral load (pVL) <25 copies/ml at testing. HIV-1 DNA was extracted and amplified from PBMCs for env gp120 sequencing. CRT was assigned by using geno2pheno and isolates were classified as X4 (FPR ≤20%) or R5 (FPR >20%). Level of serological inflammation biomarkers including IL-6, hsPCR, and D-dimers were measured.

Results

An X4 virus was evidenced in HIV-1 proviral DNA of 50 patients (42%) while the remaining 68 patients were classified as R5. The median follow-up was 19 years (range 15–25). No association was observed between CRT and sex, age, nationality, subtype, HIV risk factor, HBV/HCV co-infection, baseline CD4+ cell count and pVL, overall duration of antiretroviral therapy, past exposure to mono-or dual therapies, and duration of NNRTI or PI-based therapy. The presence of an X4 strain was associated with CD4 nadir (p = 0.005), CD4 absolute count over time (p < 0.001), and cumulative positive (copy/years) viremia (p <0.001) during the whole patient history. No differences were found between R5 and X4 patients regarding inflammation marker levels including Il-6, hsPCR and D-dimers.

Conclusions

An archived X4 virus was demonstrated in 42% of patients with a >15-year-history of HIV infection. This presence was clearly associated with a greater exposure to positive viremia and a poorer CD4 trend over time compared to R5, independent of type and duration of antiretroviral treatment. CRT does not seem to influence the inflammation rate of patients aging with HIV.
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Metadata
Title
X4 viruses are frequently archived in patients with long-term HIV infection but do not seem to influence the “inflamm-aging” process
Authors
Annalisa Saracino
Laura Monno
Luigia Scudeller
Giuseppe Bruno
Nicoletta Ladisa
Grazia Punzi
Anna Volpe
Antonella Lagioia
Gioacchino Angarano
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2013
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-13-220

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