Enrichment of HIV-1 Subtype AD Recombinants in a Ugandan Cohort of Severely Septic Patients

Najah I. Doka, Shevin T. Jacob, Patrick Banura, Christopher C. Moore, David Meya, Harriet Mayanja-Kizza, Steven J. Reynolds, W. Michael Scheld, Wen Yuan

Research output: Contribution to journalArticle

Abstract

Background: Several population-wide HIV-1 subtype distribution studies in Uganda have evaluated relatively healthy clinic patients. Given the differences in HIV-1 disease progression based on subtype, we examined HIV-1 subtype distribution and disease outcomes among hospitalized patients with severe sepsis. Methods: Patients with severe sepsis were enrolled at two hospitals in Uganda. Data collected included demographics, Karnofsky scores, highly active antiretroviral therapy (HAART) use, HIV-1 serostatus, CD4+ T cell concentration, whole blood lactate concentration, and blood cultures. HIV-1 subtypes were determined by sequencing parts of the gag and env genes, followed by phylogenetic analysis. Results: Of the 267 patients evaluated, 228 (85.4%) were HIV infected. The predominant HIV-1 subtypes were A (46%), D (17%), and AD recombinants (30%). HIV-1 subtypes B, C, and other recombinants were uncommon. Patients infected with HIV-1 subtypes A, D and AD viruses were similar in demographics, CD4+ T cell concentration, HAART use, Karnofsky scores, whole blood lactate concentration, and positive blood cultures. There was no difference in 30-day mortality from severe sepsis between the 3 groups (p = 0.99). Conclusion: A high proportion of HIV-1 subtypes A and AD recombinants was observed in this cohort of severely septic patients. The proportion of AD recombinants was higher in this cohort than in previous cohorts of Ugandan HIV-1 patients. No difference in baseline demographics, clinical factors or 30-day mortality was seen across HIV-subtypes.

Original languageEnglish (US)
Article numbere48356
JournalPloS one
Volume7
Issue number10
DOIs
StatePublished - Oct 29 2012

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)
  • General

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    Doka, N. I., Jacob, S. T., Banura, P., Moore, C. C., Meya, D., Mayanja-Kizza, H., Reynolds, S. J., Scheld, W. M., & Yuan, W. (2012). Enrichment of HIV-1 Subtype AD Recombinants in a Ugandan Cohort of Severely Septic Patients. PloS one, 7(10), [e48356]. https://doi.org/10.1371/journal.pone.0048356