Disease Progression and Survival with Human Immunodeficiency Virus Type 1 Subtype E Infection among Female Sex Workers in Thailand

Mahidol University, Krung Thep, Bangkok, Thailand
The Journal of Infectious Diseases (Impact Factor: 6). 05/2000; 181(5):1598-606. DOI: 10.1086/315469
Source: PubMed


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//*L/month), median time from infection to <200 CD4 T lymphocytes//*L (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.

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    • "Likewise, research in Thailand indicates similar patterns of pathogenesis and opportunistic infections between CRF01_AE and subtype B [56] [81]. A comparison of subtypes B and C in Israelis and Ethiopians respectively revealed no differences in immune activation profiles [15] [148]. In contrast, several studies out of Africa indicate a range of potential subtype differences. "
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    • "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). "
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