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https://www.arca.fiocruz.br/handle/icict/30102
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ArtigoDireito Autoral
Acesso aberto
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- INI - Artigos de Periódicos [3473]
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SEX-ASSOCIATED DIFFERENCES IN PRE-ANTIRETROVIRAL THERAPY PLASMA HIV-1 RNA IN DIVERSE AREAS OF THE WORLD VARY BY CD4(+) T-CELL COUNT
Autor(es)
Afiliação
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em DST/AIDS. Rio de Janeiro, RJ, Brasil.
Harvard School of Public Health. Statistical & Data Analysis Center. Boston, Massachusetts, USA.
National Institutes of Health. Office of Biotechnology Activities. Bethesda, Maryland, USA.
NIH. National Institute of Allergy and Infectious Diseases. Division of AIDS. HIV Research Branch. Bethesda, MD, USA.
University of Zimbabwe College of Health Sciences. Harare, Zimbabwe.
Brown Medical School. Providence, Rhode Island, USA.
YRG Centre for AIDS Research & Education. Chennai, India.
University of Colorado Health Sciences Center. Denver, Colorado, USA.
University of California. Los Angeles, CA, USA.
Harvard School of Public Health. Statistical & Data Analysis Center. Boston, Massachusetts, USA.
National Institutes of Health. Office of Biotechnology Activities. Bethesda, Maryland, USA.
NIH. National Institute of Allergy and Infectious Diseases. Division of AIDS. HIV Research Branch. Bethesda, MD, USA.
University of Zimbabwe College of Health Sciences. Harare, Zimbabwe.
Brown Medical School. Providence, Rhode Island, USA.
YRG Centre for AIDS Research & Education. Chennai, India.
University of Colorado Health Sciences Center. Denver, Colorado, USA.
University of California. Los Angeles, CA, USA.
Resumo em Inglês
Background: Sex differences in the natural history of HIV infection may vary between resource-rich and resource-limited settings. Methods: Baseline characteristics from a randomized clinical trial of treatment-naive subjects conducted at sites in Africa, Asia, the Caribbean, and North and South America were analysed to determine if there were significant differences by sex. Results: Of the 1,571 participants, 740 (47.1%) were women. Women had higher mean screening CD4(+) T-cell counts (mean 15 cells higher; P<0.001), lower mean haemoglobin and creatinine clearance, a lower mean baseline HIV-1 viral load (4.85 log(10) versus 5.05 log₁₀ copies/ml; P<0.001) and were less likely to have a prior AIDS diagnosis than men. The sex difference in viral load was related to CD4(+) T-cell count; however, it was independent of country and persisted within the strata with CD4(+) T-cell count <200 cells/mm³.
Conclusions: Women in resource-limited settings have lower levels of plasma HIV-1 RNA and appear to present for enrolment into clinical trials at an earlier stage of disease than men. The biological basis for lower viral load in women compared to men remains unexplained. It will be important to determine if the sex differences observed at baseline impact clinical outcomes once the PEARLS clinical trial is completed.
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