Unraveling clinical outcomes of long-term cART treatment in HIV-1 patients with or without the Brazilian GWGR motif in the V3 loop
DOI:
https://doi.org/10.1590/Keywords:
HIV-1, ART, Subtype B, GWGR signature, BrazilAbstract
The presence of genetic mutations in HIV poses a significant challenge, potentially leading to antiretroviral resistance and hampering therapeutic development. The Brazilian population has presented variations in the HIV envelope V3 loop gene, especially the GWGR motif. This motif has been linked to reduced transmission potential and slower CD4+ T cell decline. This study aimed to assess clinical outcomes in patients with HIV-1 infected with strains containing the GWGR motif compared with those without it during long-term cART. A cohort of 295 patients with HIV was examined for the GWGR motif presence in the V3 loop. A total of 58 samples showed the GWGR signature, while 237 had other signatures. Multifactorial analyses showed no significant differences in demographic characteristics, CD4+ cell count, AIDS progression, or mortality between GWGR carriers and others. However, the mean interval between the first positive HIV test and the initial AIDS-defining event was more than two times longer for women carrying the GWGR signature (p = 0.0231). We emphasize the positive impact of cART on HIV/AIDS treatment, including viral suppression, CD4+ cell preservation, and immune function maintenance. Although no significant differences were found during cART, residual outcomes reflecting adherence challenges were observed between diagnosis and the first AIDS-defining event. The previously described outcomes, highlighting statistically significant differences between individuals carrying the GPGR motif compared with those with the Brazilian GWGR motif, may be directly linked to the natural progression of infection before advancements in cART. Presently, these physicochemical aspects may no longer hold the same relevance.
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Copyright (c) 2024 Victor Ângelo Folgosi, Shirley Vasconcelos Komninakis, Luciano Lopes, Mariana Amélia Monteiro, Tatiane Assone, Luiz Augusto Marcondes Fonseca, Wilson Domingues, Pedro Domingos Leite Junior, Jefferson Russo Victor, Jorge Casseb
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Funding data
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Fundação de Amparo à Pesquisa do Estado de São Paulo
Grant numbers 2003/06870-5 and 2016/03025-2 -
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
Grant numbers 33002010060P2