Sex, Race, and Geographic Region Influence Clinical Outcomes Following Primary HIV-1 Infection
2011; Oxford University Press; Volume: 203; Issue: 4 Linguagem: Inglês
10.1093/infdis/jiq085
ISSN1537-6613
AutoresAmie L. Meditz, Samantha MaWhinney, Amanda A. Allshouse, William J. Feser, Martin Markowitz, Susan J. Little, Richard D. Hecht, Eric S. Daar, Ann C. Collier, Joseph B. Margolick, J Michael Kilby, Jean‐Pierre Routy, Brian Conway, John Kaldor, Jay A. Levy, Robert T. Schooley, David A. Cooper, Marcus Altfeld, Douglas D. Richman, Elizabeth Connick,
Tópico(s)HIV, Drug Use, Sexual Risk
ResumoIt is unknown whether sex and race influence clinical outcomes following primary human immunodeficiency virus type 1 (HIV-1) infection.Data were evaluated from an observational, multicenter, primarily North American cohort of HIV-1 seroconverters.Of 2277 seroconverters, 5.4% were women. At enrollment, women averaged .40 log₁₀ fewer copies/mL of HIV-1 RNA (P < .001) and 66 more CD4(+) T cells/μL (P = .006) than men, controlling for age and race. Antiretroviral therapy (ART) was less likely to be initiated at any time point by nonwhite women and men compared to white men (P < .005), and by individuals from the southern United States compared to others (P = .047). Sex and race did not affect responses to ART after 6 months (P > .73). Women were 2.17-fold more likely than men to experience >1 HIV/AIDS-related event (P < .001). Nonwhite women were most likely to experience an HIV/AIDS-related event compared to all others (P = .035), after adjusting for intravenous drug use and ART. Eight years after diagnosis, >1 HIV/AIDS-related event had occurred in 78% of nonwhites and 37% of whites from the southern United States, and 24% of whites and 17% of nonwhites from other regions (P < .001).Despite more favorable clinical parameters initially, female HIV-1-seroconverters had worse outcomes than did male seroconverters. Elevated morbidity was associated with being nonwhite and residing in the southern United States.
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