Disease progression and survival with human immunodeficiency virus type 1 subtype E infection among female sex workers in Thailand
ABSTRACT This study describes rates and correlates of disease progression and survival among 194 female sex workers in northern Thailand who were infected with human immunodeficiency virus type 1 (HIV-1; 96% with subtype E). The median rate of CD4 T lymphocyte decline (3.9 cells/microL/month), median time from infection to <200 CD4 T lymphocytes/microL (6.9 years), and time to 25% mortality (6.0 years) were similar to those found in studies performed in Western countries before highly active antiretroviral therapy was available to populations infected with HIV-1 subtype B. Mortality rates among women with >100,000 HIV-1 RNA copies/mL were 15.4 times higher (95% confidence interval, 5.2-45.2) than among women with <10,000 copies. Initial CD4 T lymphocyte counts and serum virus load were independently strong predictors of survival. These results can help in assessing the effects of the epidemic in Thailand and in determining the prognoses for individual patients.
- SourceAvailable from: Preston A Marx
[Show abstract] [Hide abstract]
- "Likewise, research in Thailand indicates similar patterns of pathogenesis and opportunistic infections between CRF01_AE and subtype B  . A comparison of subtypes B and C in Israelis and Ethiopians respectively revealed no differences in immune activation profiles  . In contrast, several studies out of Africa indicate a range of potential subtype differences. "
ABSTRACT: The devastating consequences of AIDS pandemic will probably only be controlled when a vaccine is developed that is safe, effective, affordable, and simple enough to permit implementation in developing countries where the impact of AIDS is most severe. However, the major obstacle for the control of the spread of AIDS lies in the diversity of HIV and its enormous evolutionary potential. Numerous HIV forms contribute to the AIDS pandemic. Two viral types (HIV-1 and HIV-2), numerous groups (M, N and O for HIV-1 and A through H for HIV-2) and numerous subtypes, sub-subtypes and circulating recombinant forms (CRF) have emerged during the last 50 years. At least nine different genetic HIV-1 subtypes and over 20 CRFs were defined within group M, which accounts for the majority of cases in the AIDS pandemic. Even though HIV-1 subtype C and A predominate globally, the other viral forms co-circulate all over the world and may have a major impact for the strategies of pandemic control. Here we discuss the distribution of these divergent viral forms worldwide and the potential consequences of such a tremendous viral diversity for diagnostic, monitoring, treatment and the development of an effective vaccine.Current HIV research 02/2007; 5(1):23-45. DOI:10.2174/157016207779316297 · 2.14 Impact Factor
[Show abstract] [Hide abstract]
- "Similarly, the estimated loss in absolute CD4 numbers in placebo group agrees well with published longitudinal surveys in a comparable group of patients who either did not respond to HAART or interrupted their treatment (Palella et al., 2003; Tebas et al., 2002). This estimate is also in agreement with a longitudinal survey of disease progression among non-treated female sex workers in northern Thailand, with median decline of −3.9 CD4 cells/month (Kilmarx et al., 2000). A similar rate of progressive lymphocytopenia equivalent to −3.2 cells/month has been reported among 605 injecting drug users who started with a median 513 CD4 lymphocytes (Lyles et al., 1997). "
ABSTRACT: V-1 Immunitor (V1) is an oral AIDS vaccine containing heat- and chemically-inactivated viral antigens derived from pooled blood of HIV-positive donors. V1 has a pending status as an investigational drug but is currently marketed as a dietary supplement. Earlier published, uncontrolled studies of V1 demonstrated body weight gain, increase in T-lymphocyte numbers, decrease in viral load, and improved survival of end-stage AIDS patients. In order to substantiate prior observations we have undertaken a placebo-controlled phase II clinical trial involving 47 antiviral therapy naive, asymptomatic individuals who had over 350 mm(3) CD4 T-cells (mean/median 538/480) at study entry. Both placebo and treatment arms were identical demographically and by every clinical parameter measured at baseline. At the end of 6-month follow-up 29 volunteers who received V1 b.i.d. had gained on average 43 CD4 T-cells (540 versus 583). This gain was statistically significant (p=0.01) while changes in T-cell numbers in placebo group failed to reach the significance threshold (p=0.33). The clinical potential of V1 is further supported by an elevation in CD4/CD8 ratio among V1 recipients and decline in CD4/CD8 ratio in patients on placebo (0.575 versus 0.524; p=0.02). The average weight gain among patients on V1 was 1.8 kg while placebo group lost 0.5 kg. These results suggest that V1 may delay or reverse the disease progression without any concurrent toxicity and support our prior open-label studies indicating that V1 confers clinical benefit. A phase III clinical study is required to confirm these findings and to allow us to seek license for V1 as a therapeutic AIDS vaccine.Journal of Clinical Virology 01/2005; 31 Suppl 1:S55-62. DOI:10.1016/j.jcv.2004.09.002 · 3.47 Impact Factor