Nonrandom development of immunologic abnormalities after infection with human immunodeficiency virus: implications for immunologic classification of the disease.

Abstract Human immunodeficiency virus (HIV)-1–infected long-term nonprogressors (LT-NP) represent less than 5% of HIV-1–infected patients. In this work, we tried to understand whether combined genotypes of CCR5-▵32, CCR2-64I, SDF1-3′A and HLA alleles can predict the LT-NP status. Among the chemokine receptor genotypes, only the frequency of the CCR5-▵32 allele was significantly higher in LT-NP compared with the group of standard progressors. The predominant HLA alleles in LT-NP were HLA-A3, HLA-B14, HLA-B17, HLA-B27, HLA-DR6, and HLA-DR7. A combination of both HLA and chemokine receptor genotypes integrated in a multivariate logistic regression model showed that if a subject is heterozygous for CCR5-▵32 and homozygous for SDF1 wild type, his odds of being LT-NP are increased by 16-fold, by 47-fold when a HLA-B27 allele is present with HLA-DR6 absent, and by 47-fold also if at least three of the following alleles are present: HLA-A3, HLA-B14, HLA-B17, HLA-DR7. This model allowed a correct classification of 70% of LT-NPs and 81% of progressors, suggesting that the host’s genetic background plays an important role in the evolution of HIV-1. The chemokine receptor and chemokine genes along with the HLA genotype can serve as predictors of HIV-1 outcome for classification of HIV-1–infected subjects as LT-NPs or progressors.

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Diagnostic Classification of Neuropsychiatric Signs and Symptoms in Patients With Dementia

International Psychogeriatrics ◽

10.1017/s1041610297003475 ◽

1997 ◽

Vol 8 (S3) ◽

pp. 273-279 ◽

Cited By ~ 2

Author(s):

Eric D. Caine

Keyword(s):

Human Immunodeficiency Virus ◽

Clinical Research ◽

Medical Diagnosis ◽

Chronic Headache ◽

Signs And Symptoms ◽

Diagnostic Classification ◽

Persistent Diarrhea ◽

Immunodeficiency Virus ◽

Irritable Bowel

Establishing a medical diagnosis serves two utilitarian purposes: providing information necessary to initiate treatment and communicating information regarding prognosis. A nosology or diagnostic nomenclature (i.e., a classification of diagnoses) provides further utility by establishing a foundation for clinical research. In his book, Wulff outlined four types of diagnoses: (1) symptomatic or pseudoanatomic diagnoses (e.g., chronic headache, persistent diarrhea, or irritable bowel); (2) syndromes; (3) anatomic diagnoses; and (4) causal diagnoses. By definition, syndromes have no means of being validated by measures external to the constructs themselves. Often, specific syndromes reflect diverse origins, and conversely, specific etiologies may cause multiple syndromes (e.g., syphilis, human immunodeficiency virus, and diabetes).

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The subtypes of human immunodeficiency virus in Australia and Asia

Sexual Health ◽

10.1071/sh03002 ◽

2004 ◽

Vol 1 (1) ◽

pp. 1 ◽

Cited By ~ 6

Author(s):

Robert Oelrichs

Keyword(s):

Human Immunodeficiency Virus ◽

Genetic Variability ◽

Distribution Patterns ◽

Human Populations ◽

Regional Diversity ◽

Subtype B ◽

Immunodeficiency Virus ◽

Australasian Region ◽

Hiv 1

Worldwide, the human immunodeficiency virus exhibits a great genetic variability, with multiple circulating subtypes of the virus. This variability allows study of the movement of HIV strains within and between human populations but also has implications for diagnosis, treatment and monitoring. The type of HIV causing the epidemic in Australia is changing from being homogeneous subtype B, reflecting a greater regional diversity. In this paper the classification of HIV-1 subtypes and their distribution within the Australasian region are reviewed and the implications of these distribution patterns discussed.

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TESTING A SUBTYPE-SPECIFIC GP41 AMPLIFICATION METHOD FOR GENOTYPING INDIVIDUALS INFECTED BY HUMAN IMMUNODEFICIENCY VIRUS TYPE-1 IN THE BRAZILIAN POPULATION OF ITAJAÍ, SOUTH BRAZIL

Revista do Instituto de Medicina Tropical de São Paulo ◽

10.1590/s0036-46652013000200005 ◽

2013 ◽

Vol 55 (2) ◽

pp. 91-99 ◽

Cited By ~ 1

Author(s):

Liã Bárbara Arruda ◽

Laura I. Weber ◽

Marisa dos Santos ◽

Edson M. Kawakubo ◽

Ana Maria B. Martínez

Keyword(s):

Human Immunodeficiency Virus ◽

Viral Load ◽

Pcr Amplification ◽

Subtype B ◽

Immunodeficiency Virus ◽

Reference Sequences ◽

Hiv 1 ◽

South Brazil

The method used by YAGYU et al. for the subtype-specific polymerase chain reaction (PCR) amplification of the gp41 transmembrane region of the human immunodeficiency virus type-1 (HIV-1) env gene, was tested. HIV-1 proviral DNA from 100 infected individuals in Itajaí, South Brazil was used to analyze this method. Seventy individuals were determined according to this method as having PCR products at the expected size for subtypes B, C, D and F. Of these individuals, 26 (37.1%) were observed as having the expected amplification for subtype C, and 42 (60%) were observed as having the expected products for subtypes B and D. Of the subtype B and D amplicons, 16 (22.9%) were classified as subtype D, and 26 (37.1%) were classified as subtype B. Two individuals (2.9%) had amplicons that were observed after subtype F-specific amplification was performed. Sequencing and comparing the patient sequences to reference sequences confirmed the classification of sequences of subtypes C and B. However, sequences that were falsely determined as being D and F in the PCR assay were determined as being subtypes C and B, respectively, by sequence analysis. For those individuals from whom no amplified products were obtained, a low viral load that was indicated in their patient history may explain the difficulty in subtyping by PCR methods. This issue was demonstrated by the results of ANOVA when testing the effect of viral load on the success of PCR amplification. The alignment of the obtained sequences with HIV-1 reference sequences demonstrated that there is high intra-subtype diversity. This indicates that the subtype-specific primer binding sites were not conserved or representative of the subtypes that are observed in the Brazilian populations, and that they did not allow the correct classification of HIV-1 subtypes. Therefore, the proposed method by YAGYU et al. is not applicable for the classification of Brazilian HIV-1 subtypes.

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