Impact of HIV-1 tropism on the emergence of non-AIDS events in HIV-infected patients receiving fully suppressive antiretroviral therapy

OBJECTS: The impact of HIV-1 tropism on the emergence of non-AIDS events was evaluated in a cohort of 116 antiretroviral (ART) responder patients. METHODS: The patients were followed for the emergence of hypertension, renal impairment, metabolic and bone disorders (defined as non-AIDS events) each 8 weeks at standard visits. A V3 plasma sequence genotype analysis was performed at the time of ART initiation and the geno2pheno algorithm with the results that defines the false positive rate (FPR) was used to infer HIV tropism. The associations between the non-AIDS events and the FPR at baseline were evaluated using the Chi-squared test for trend. A Cox regression analysis using the counting process formulation of Andersen and Gill was performed to define whether the emergence of non-AIDS events was correlated to FPR. RESULTS: The prevalence of at least one non-AIDS event resulted higher in patients with a FPR <10% than in patients with a R5 virus (p-value = 0.033). Patients with a FPR <5.0% most frequently developed non-AIDS events during ART (p value = 0.01). A higher prevalence of patients with at least 2 AIDS events was found in the group of subjects with a FPR <5.0% respect to the others (p-value<0.001). At multivariate Cox regression analysis, having a X4 virus and age were independently associated with a higher probability of non-AIDS event development. CONCLUSION: This study shows that an X4 virus, particularly a FPR <5%, is related to non-AIDS events development. Further studies are warranted to understand the mechanisms underlying this phenomenon.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0.