Clinical differences and viral diversity between newly HIV type 1-diagnosed African and non-African patients in Spain (2005-2007)

Gonzalo Yebra, Pablo Rivas, María Dolores Herrero, Marisa López, Miguel de Mulder, Sabino Puente, Germán Ramírez-Olivencia, Vincent Soriano, Africa Holguín

Research output: Contribution to journalArticlepeer-review

Abstract

Abstract The diagnosis of HIV-1 is increasing in African-born persons residing in Europe. They present a high prevalence of HIV-1 non-B variant infections and of parasitic infections, both of which are infrequent in Western countries. Immigration favors their presence in nonendemic countries. In this study, all newly HIV-diagnosed individuals at an HIV/AIDS and Tropical Medicine reference center in Madrid from 2005 through 2007 were retrospectively studied. HIV-1 subtyping was performed in gag, pol, and gp41 coding regions by phylogenetic analyses. The presence of other pathogens was also evaluated. Furthermore, all HIV-1-infected Africans were screened for parasitic infections. Newly diagnosed HIV-1 subjects included 90 sub-Saharan Africans and 188 non-Africans (116 Spaniards, 13 other Europeans, and 59 Latin Americans). Significantly higher numbers of HIV-1-infected Africans than non-Africans were females, acquired HIV-1 by heterosexual contact, and presented a more advanced clinical CDC stage and criteria for starting antiretroviral therapy in the first clinical visit. They predominantly carried non-B subtype infections, mainly intersubtype recombinants. Half of HIV-1-infected Africans had parasitic infections. CD4(+) T cell counts were lower among Africans than Europeans at the time of HIV-1 diagnosis. At 12 months of follow-up after starting antiretroviral treatment, a significantly lower proportion of Africans than non-Africans achieved undetectable viremia due to their higher loss to follow-up. However, CD4(+) T cell recovery and virological failure rates were similar. Therefore, the profile of African HIV-1-infected immigrants varies widely with respect to Spanish HIV-infected individuals. More advanced immunodeficiency and the coexistence of parasitic diseases and infections with a large diversity of HIV-1 non-B and recombinant variants are expected.

Original languageEnglish
Pages (from-to)37-44
Number of pages8
JournalAids research and human retroviruses
Volume25
Issue number1
DOIs
Publication statusPublished - Jan 2009

Keywords

  • Adult
  • Animals
  • CD4 Lymphocyte Count
  • Cluster Analysis
  • Ethnic Groups
  • Female
  • Genotype
  • HIV Infections
  • HIV-1
  • Humans
  • Male
  • Middle Aged
  • Molecular Epidemiology
  • Molecular Sequence Data
  • Phylogeny
  • Polymorphism, Genetic
  • Retrospective Studies
  • Sequence Analysis, DNA
  • Sequence Homology
  • Spain
  • Viral Load
  • Viral Proteins
  • Comparative Study
  • Journal Article
  • Research Support, Non-U.S. Gov't

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