AEGiS-14IAC: Survival of Ugandan infants with subtype A and D HIV-1 infection (HIVNET 012).

14th International AIDS Conference


Barcelona, Spain - July 7-12, 2002

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Survival of Ugandan infants with subtype A and D HIV-1 infection (HIVNET 012).

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. B10215)

Eshleman SH, Guay LA, Fleming T, Mwatha A, Mracna M, Becker-Pergola G, Musoke P, Mmiro F, Jackson JB
The Johns Hopkins Medical Institutions, Baltimore, MD, United States

BACKGROUND: Virologic factors may influence survival of HIV-1 infected infants. We compared the survival of Ugandan infants with subtype A and D HIV-1 infection. This study was performed in the context of the Ugandan clinical trial, HIVNET 012, which compared the efficacy of single dose nevirapine (NVP) and short course zidovudine (AZT) for prevention of HIV-1 mother-to-child transmission (MTCT).

METHODS: HIV-1 subtypes were determined by phylogenetic analysis of HIV-1 protease and reverse transcriptase sequences from 32 women in the NVP arm and 54 women in the AZT arm of HIVNET 012 whose infants were HIV-1 infected by 6-8 weeks of age. This identified 43 infants with subtype A and 29 infants with subtype D infection. We compared the proportion of infants with subtype A vs. D who died by 18 months of age, and the association of subtype with the continuous outcome of survival. For overall survival, a Cox proportional hazards model was used to determine the association between HIV-1 subtype (A vs. D) and infant death, adjusting for baseline covariates, maternal viral load and maternal CD4 cell count.

RESULTS: Among infants in the NVP arm, the proportion of infants who died within 18 months of age was 60% for subtype A and 18% for subtype D infection. However, the difference was not statistically significant. The proportion of infants who died by 18 months of age in the AZT arm and in the AZT and NVP arms combined was similar for infants with subtype A vs. D. Similar results were obtained when assessing the association of subtype with the continuous outcome of survival.

CONCLUSIONS: HIV-1 subtype was not significantly associated with survival of HIV-1 infected infants in this cohort. This may reflect the relatively small sample size in our study. Additional studies are needed to evaluate further whether HIV-1 subtype influences clinical outcome in pediatric HIV-1 infection.

Keywords: AEGIS, HIV Infections, Nevirapine, HIV-1, Viral Load, Zidovudine, CD4 Lymphocyte Count, HIV-1 Reverse Transcriptase, HIV Protease, Survival, RNA-Directed DNA Polymerase, Infant, Human, Female, Child, MortalityKWDaegis,hivinfections,nevirapine,hiv-1,viralload,zidovudine,cd4lymphocytecount,hiv-1reversetranscriptase,hivprotease,survival,rna-directeddnapolymerase,infant,human,female,child,mortality

020707
B10215

Copyright © 2002 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.