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The effect of HIV-1 subtypes on HIV ...

Case Western Reserve University.

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The effect of HIV-1 subtypes on HIV transmission and disease progression in Rakai District, Uganda.

Record Type:	Language materials, printed : Monograph/item
Title/Author:	The effect of HIV-1 subtypes on HIV transmission and disease progression in Rakai District, Uganda./
Author:	Kiwanuka, Noah.
Description:	203 p.
Notes:	Adviser: Christopher C. Whalen.
Contained By:	Dissertation Abstracts International69-02B.
Subject:	Biology, Biostatistics. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoeng/servlet/advanced?query=3302489
ISBN:	9780549477778

The effect of HIV-1 subtypes on HIV transmission and disease progression in Rakai District, Uganda.
Kiwanuka, Noah.

The effect of HIV-1 subtypes on HIV transmission and disease progression in Rakai District, Uganda. - 203 p.

Adviser: Christopher C. Whalen.

Thesis (Ph.D.)--Case Western Reserve University, 2008.

Keywords: HIV-1 subtypes, HIV transmission, disease progression.

ISBN: 9780549477778Subjects--Topical Terms:

1018416
Biology, Biostatistics.

The effect of HIV-1 subtypes on HIV transmission and disease progression in Rakai District, Uganda.
LDR:03216nam 2200325 a 45 001 856649
005 20100709
008 100709s2008 ||||||||||||||||| ||eng d
020 $a 9780549477778
035 $a (UMI)AAI3302489
035 $a AAI3302489
040 $a UMI $c UMI
100 1 $a Kiwanuka, Noah. $3 1023483
245 1 4 $a The effect of HIV-1 subtypes on HIV transmission and disease progression in Rakai District, Uganda.
300 $a 203 p.
500 $a Adviser: Christopher C. Whalen.
500 $a Source: Dissertation Abstracts International, Volume: 69-02, Section: B, page: 0912.
502 $a Thesis (Ph.D.)--Case Western Reserve University, 2008.
520 $a Keywords: HIV-1 subtypes, HIV transmission, disease progression.
520 $a Objectives. To determine whether HIV transmission and disease progression differ by HIV-1 subtype.
520 $a Methods. The effect of HIV-1 subtypes on HIV transmission and disease progression was investigated using data from community-based cohort studies in Rakai district, Uganda. HIV-1 subtype was determined by genomic sequencing of the gag and gp41 viral regions and by the Multi-region Hybridization Assay (MHA). HIV viral loads were determined by Roche Amplicor v1.5, and CD4+ T cell counts by BD Facscalibur system. Adjusted measures of association were estimated using Poisson regression model, linear mixed effects model, and Cox proportional hazards model.
520 $a Results. Adjusting for age, viral load, and genital ulcers (GUD), HIV transmission was higher for subtype A relative subtype D (Rate ratio, 1.98; 95% CI, 1.17--3.34). Age (<30 years) of the positive partner (RR, 3.98; 95% CI, 1.90--8.35), GUD (RR, 1.83; 95% CI, 1.16--2.89), and viral load (RR, 2.17; 95% CI, 1.60--2.94) were significant risk factors for HIV transmission. Regardless of subtype, the rate of CD4+ T cell loss (cells/muL per year) was -31.6 (95% CI; -44.6, -18.6), adjusted for age, baseline CD4 counts, and viral load. Adjusted rate of CD4+ cell loss was -8.8 (95% CI; -35.1, 17.4) for subtype A, -34.3 (95% CI; -64.0, -4.6) for R, -37.5 (95% CI; -54.1, -20.8) for subtype D, and -77.5 (95% CI; -136.6, -18.4) for M. The median time from seroconversion to AIDS was shorter for subtypes D, R and M (6.5, 5.6, and 5.8 years, respectively), compared with A (8.0 years; p = 0.022). Relative to subtype A, adjusted hazard ratios (95% CI) of progression to AIDS were 2.13 (1.10--4.11) for subtype D, 2.16 (1.05--4.45) for recombinants, and 4.40 (1.71--11.3) for infection with multiple HIV strains.
520 $a Conclusions. In Rakai, subtype A has a higher rate of HIV transmission than subtype D or inter-subtype recombinants. However, subtype A has a slower rate of progression to AIDS compared to subtype D, recombinants, and multiple HIV strains. Determination of HIV-1 subtype may be important in trials of preventive and therapeutic HIV-1 vaccines and in the management of HIV infected individuals.
590 $a School code: 0042.
650 4 $a Biology, Biostatistics. $3 1018416
650 4 $a Health Sciences, Epidemiology. $3 1019544
690 $a 0308
690 $a 0766
710 2 $a Case Western Reserve University. $3 1017714
773 0 $t Dissertation Abstracts International $g 69-02B.
790 $a 0042
790 1 0 $a Whalen, Christopher C., $e advisor
791 $a Ph.D.
792 $a 2008
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoeng/servlet/advanced?query=3302489