1. bookVolume 21 (2013): Issue 2 (June 2013)
Journal Details
License
Format
Journal
eISSN
2284-5623
ISSN
2284-5623
First Published
08 Aug 2013
Publication timeframe
4 times per year
Languages
English
access type Open Access

Sex differences in HIV-1 viral load and absolute CD4 cell count in long term survivors HIV-1 infected patients from Giurgiu, Romania

Published Online: 21 Jun 2013
Page range: 217 - 224
Journal Details
License
Format
Journal
eISSN
2284-5623
ISSN
2284-5623
First Published
08 Aug 2013
Publication timeframe
4 times per year
Languages
English
Abstract

Introduction: Prior studies assessing sex differences correlated with the levels of human immunodeficiency virus (HIV) RNA and absolute CD4 cell count in adults and children, treated or untreated with antiretroviral (ARV) therapy presented conflicting results. Objective: To assess comparative HIV RNA levels and absolute CD4 cell count in men and women from a large cohort of HIV-infected long term survivors patients. Methods: 462 HIV infected patients were analyzed cross-sectionally and longitudinally after being split into three groups: 156 naïve deceased patients, median age at death 10 years, 197 ARV treated patients, median age 17 years and 109 ARV treated patients, median age 23 years followed up until 2011. HIV RNA and absolute CD4 cell count were measured in all patients enrolled in the study. Results: In cross-sectional analysis of 156 naïve patients HIV RNA median levels were lower in females comparing to males, 4.95 vs. 5.73 HIV RNA log10 (copies/ml). Female absolute CD4 cell count was slightly higher, (median 97 vs. 65.5 cells/μL; P = 0.0001). Cross-sectional analysis of 197 ARV treated patients showed a lower log10 HIV RNA level in females compared to males, (P=0.0001), and also lower median CD4 count values in women, 336 cells/μL vs 456 cells/μL in men, P=.0001. Longitudinal analysis revealed statistically significant results: mean log viral loads were lower in females (F=13.90, P= 0.0009) and absolute CD4 cell count was lower in malse (F=16.72, P<0.0001), almost across all tested ages. Conclusion: We report steady sex differences in HIV RNA levels and absolute CD4 cell count in ART-treated HIV-infected patients, a fact that may suggest a reevaluation of our current treatment strategies according to sex.

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1. Anastos K, Gange SJ, Lau B, Weiser B, Detels R, Giorgi JV et al. Association of race and gender with HIV-1 RNA levels and immunologic progression. J Acquir Immune Defic Syndr 2000; (24):218-26.10.1097/00126334-200007010-00004Search in Google Scholar

2. Rezza G, Lepri AC, d’Arminio Monforte A, Pezzotti P, Castelli F, Dianzani F et al. Plasma viral load concentrations in women and men from different exposure categories and with known duration of HIV infection. ICONA Study Group. J Acquir Immune Defic Syndr 2000; (25):56-62.10.1097/00126334-200009010-00008Search in Google Scholar

3. Kalish LA, Collier AC, Flanigan TP, Kumar PN. Plasma human immunodeficiency virus (HIV) type 1 RNA load in men and women with advanced HIV-1 disease. J Infect Dis 2000; (182):603-6.10.1086/315710Search in Google Scholar

4. Moroni M. Sex differences in HIV-1 viral load and progression to AIDS: ICONA Study Group. Italian cohort of HIV-1 positive individuals [letter; comment]. Lancet 1999; (353):589-90.10.1016/S0140-6736(05)75646-4Search in Google Scholar

5. Moore R, Cheever L, Keruly J, Chaisson R. Lack of sex difference in CD4 to HIV-1 RNA viral load ratio. Lancet 1999; (353):463-4.10.1016/S0140-6736(98)05379-3Search in Google Scholar

6. Junghans C, Ledergerber B, Chan P, Weber R, Egger M. Sex differences in HIV-1 viral load and progression to AIDS. Lancet 1999; (353):589.10.1016/S0140-6736(05)75645-2Search in Google Scholar

7. Lyles C, Dorrucci M, Vlahov D, Pezzotti P, Angarano G, Sinicco A et al. Longitudinal human immunodeficiency virus type 1 load in the Italian Seroconversion Study: correlates and temporal trends of virus load. J Infect Dis 1999; (180): 1018-24.10.1086/31498010479126Search in Google Scholar

8. Sterling T, Lyles C, Vlahov D, Astemborski J, Margolick J, Quinn T.Sex differences in longitudinal human immunodeficiency virus type 1 RNA levels among seroconverters. J Infect Dis 1999; (180):666-72.10.1086/31496710438353Search in Google Scholar

9. Evans JS, Nims T, Cooley J, Bradley W, Jagodzinski L, Zhou S et al. Serum levels of virus burden in earlystage human immunodeficiency virus type 1 disease in women. J Infect Dis 1997; (175):795-800.10.1086/5139739086132Search in Google Scholar

10. Sterling TR, Vlahov D, Astemborski J, Hoover DR, Margolick JB, Quinn TC. Initial plasma HIV-1 RNA levels and progression to AIDS in women and men. N Engl J Med 2001; (344):720-5.10.1056/NEJM20010308344100311236775Search in Google Scholar

11. Fish EN. The X-files in immunity: sex-based differences predispose immune responses. Nat Rev Immunol 2008; (8):737-744.10.1038/nri2394709721418728636Search in Google Scholar

12. Bouman A, Heineman MJ, Faas MM. Sex hormones and the immune response in humans. Hum Reprod Update 2005; (11):411-423.10.1093/humupd/dmi00815817524Search in Google Scholar

13. Ruel TD, Zanoni BC, Ssewanyana I, Cao H, Havlir DV, Kamya M, et al. Sex differences in HIV RNA level and CD4 cell percentage during childhood. Clin. Infect. Dis. 2011 Sep;53(6):592-9.10.1093/cid/cir484316080521840929Search in Google Scholar

14. CNLAS. Comisia Nationala de Lupta Anti Sida. Report on HIV/AIDS infection at the 1st December 2012.http://www.cnlas.ro/date-statistice/ (accesed at 4th April 2013)Search in Google Scholar

15. Foca M, Moye J, Chu C, Matthews Y, Rich K, Handelsman E et al. Gender differences in lymphocyte populations, plasma HIV RNA levels, and disease progression in a cohort of children born to women infected with HIV. Pediatrics 2006; (118):146-155.10.1542/peds.2005-029416818560Search in Google Scholar

16. European Collaborative Study. Are there gender and race differences in cellular immunity patterns over age in infected and uninfected children born to HIV-infected women? J Acquir Immune Defic Syndr 2003; (33):635-641.10.1097/00126334-200308150-0001312902809Search in Google Scholar

17. Antiretroviral Therapy for HIV Infection in Infants and Children: towards universal access. Recommendations for a public health approach, WHO Library Cataloguing, Austria, 2010, WHO, Chapter 11. First-line regimen treatment failure; When to switch regimens - Principles, 50.Search in Google Scholar

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