HIV-1 subtype C is not associated with higher risk of heterosexual HIV-1 transmission: A multinational study among HIV-1 serodiscordant couples

Erin Kahle, Mary Campbell, Jairam Lingappa, Deborah Donnell, Connie Celum, Connie WOndondo, Andrew Mujugira, Kenneth Fife, Nelly Mugo, Saidi Kapiga, James I. Mullins, Jared M. Baeten

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: HIV-1 subtype C has emerged as the most prevalent strain of HIV-1 worldwide, leading to speculation that subtype C may be more transmissible than other subtypes. We compared the risk of HIV-1 transmission for subtype C versus non-C subtypes (A, D, G and recombinant forms) among heterosexual African HIV-1 serodiscordant couples. Methods: We conducted a nested case-control analysis using data from two prospective cohort studies of heterosexual HIV-1 serodiscordant couples from six countries in eastern and southern Africa. Cases (N=121) included incident HIV-1 transmissions that were established as linked within the serodiscordant partnership by viral sequencing; controls (N=501) were nontransmitting HIV-1-infected partners. Subtype was determined for partial env and gag genes. Multiple logistic regression controlled for age and gender of the HIV-1-nfected partner and self-reported unprotected sex. Plasma and genital HIV-1 RNA concentrations were compared between subtype C and non-C subtypes using generalized estimating equations. Results: HIV-1 subtype C was not associated with increased risk of HIV-1 transmission compared with non-C subtypes: env adjusted odds ratio (adjOR) 1.14 [95% confidence interval (CI) 0.74-1.75, P=0.6] and gag adjOR 0.98 (95% CI 0.63-1.52, P=0.9). Plasma and genital HIV-1 RNA levels did not differ significantly for subtype C versus non-C. Conclusion: In a geographically diverse population of heterosexual African HIV-1 serodiscordant couples, subtype C was not associated with greater risk of HIV-1 transmission compared with non-C subtypes, arguing against the hypothesis that subtype C is more transmissible compared with other common subtypes.

Original languageEnglish
Pages (from-to)235-243
Number of pages9
JournalAIDS
Volume28
Issue number2
DOIs
StatePublished - Jan 14 2014

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Heterosexuality
HIV-1
Odds Ratio
RNA
Confidence Intervals
gag Genes
env Genes
Unsafe Sex
Southern Africa
Eastern Africa
Cohort Studies

Keywords

  • Africa
  • HIV-1 subtype
  • Serodiscordant couples
  • Transmission

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

HIV-1 subtype C is not associated with higher risk of heterosexual HIV-1 transmission : A multinational study among HIV-1 serodiscordant couples. / Kahle, Erin; Campbell, Mary; Lingappa, Jairam; Donnell, Deborah; Celum, Connie; WOndondo, Connie; Mujugira, Andrew; Fife, Kenneth; Mugo, Nelly; Kapiga, Saidi; Mullins, James I.; Baeten, Jared M.

In: AIDS, Vol. 28, No. 2, 14.01.2014, p. 235-243.

Research output: Contribution to journalArticle

Kahle, E, Campbell, M, Lingappa, J, Donnell, D, Celum, C, WOndondo, C, Mujugira, A, Fife, K, Mugo, N, Kapiga, S, Mullins, JI & Baeten, JM 2014, 'HIV-1 subtype C is not associated with higher risk of heterosexual HIV-1 transmission: A multinational study among HIV-1 serodiscordant couples', AIDS, vol. 28, no. 2, pp. 235-243. https://doi.org/10.1097/QAD.0000000000000024
Kahle, Erin ; Campbell, Mary ; Lingappa, Jairam ; Donnell, Deborah ; Celum, Connie ; WOndondo, Connie ; Mujugira, Andrew ; Fife, Kenneth ; Mugo, Nelly ; Kapiga, Saidi ; Mullins, James I. ; Baeten, Jared M. / HIV-1 subtype C is not associated with higher risk of heterosexual HIV-1 transmission : A multinational study among HIV-1 serodiscordant couples. In: AIDS. 2014 ; Vol. 28, No. 2. pp. 235-243.
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abstract = "Background: HIV-1 subtype C has emerged as the most prevalent strain of HIV-1 worldwide, leading to speculation that subtype C may be more transmissible than other subtypes. We compared the risk of HIV-1 transmission for subtype C versus non-C subtypes (A, D, G and recombinant forms) among heterosexual African HIV-1 serodiscordant couples. Methods: We conducted a nested case-control analysis using data from two prospective cohort studies of heterosexual HIV-1 serodiscordant couples from six countries in eastern and southern Africa. Cases (N=121) included incident HIV-1 transmissions that were established as linked within the serodiscordant partnership by viral sequencing; controls (N=501) were nontransmitting HIV-1-infected partners. Subtype was determined for partial env and gag genes. Multiple logistic regression controlled for age and gender of the HIV-1-nfected partner and self-reported unprotected sex. Plasma and genital HIV-1 RNA concentrations were compared between subtype C and non-C subtypes using generalized estimating equations. Results: HIV-1 subtype C was not associated with increased risk of HIV-1 transmission compared with non-C subtypes: env adjusted odds ratio (adjOR) 1.14 [95{\%} confidence interval (CI) 0.74-1.75, P=0.6] and gag adjOR 0.98 (95{\%} CI 0.63-1.52, P=0.9). Plasma and genital HIV-1 RNA levels did not differ significantly for subtype C versus non-C. Conclusion: In a geographically diverse population of heterosexual African HIV-1 serodiscordant couples, subtype C was not associated with greater risk of HIV-1 transmission compared with non-C subtypes, arguing against the hypothesis that subtype C is more transmissible compared with other common subtypes.",
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AU - Campbell, Mary

AU - Lingappa, Jairam

AU - Donnell, Deborah

AU - Celum, Connie

AU - WOndondo, Connie

AU - Mujugira, Andrew

AU - Fife, Kenneth

AU - Mugo, Nelly

AU - Kapiga, Saidi

AU - Mullins, James I.

AU - Baeten, Jared M.

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N2 - Background: HIV-1 subtype C has emerged as the most prevalent strain of HIV-1 worldwide, leading to speculation that subtype C may be more transmissible than other subtypes. We compared the risk of HIV-1 transmission for subtype C versus non-C subtypes (A, D, G and recombinant forms) among heterosexual African HIV-1 serodiscordant couples. Methods: We conducted a nested case-control analysis using data from two prospective cohort studies of heterosexual HIV-1 serodiscordant couples from six countries in eastern and southern Africa. Cases (N=121) included incident HIV-1 transmissions that were established as linked within the serodiscordant partnership by viral sequencing; controls (N=501) were nontransmitting HIV-1-infected partners. Subtype was determined for partial env and gag genes. Multiple logistic regression controlled for age and gender of the HIV-1-nfected partner and self-reported unprotected sex. Plasma and genital HIV-1 RNA concentrations were compared between subtype C and non-C subtypes using generalized estimating equations. Results: HIV-1 subtype C was not associated with increased risk of HIV-1 transmission compared with non-C subtypes: env adjusted odds ratio (adjOR) 1.14 [95% confidence interval (CI) 0.74-1.75, P=0.6] and gag adjOR 0.98 (95% CI 0.63-1.52, P=0.9). Plasma and genital HIV-1 RNA levels did not differ significantly for subtype C versus non-C. Conclusion: In a geographically diverse population of heterosexual African HIV-1 serodiscordant couples, subtype C was not associated with greater risk of HIV-1 transmission compared with non-C subtypes, arguing against the hypothesis that subtype C is more transmissible compared with other common subtypes.

AB - Background: HIV-1 subtype C has emerged as the most prevalent strain of HIV-1 worldwide, leading to speculation that subtype C may be more transmissible than other subtypes. We compared the risk of HIV-1 transmission for subtype C versus non-C subtypes (A, D, G and recombinant forms) among heterosexual African HIV-1 serodiscordant couples. Methods: We conducted a nested case-control analysis using data from two prospective cohort studies of heterosexual HIV-1 serodiscordant couples from six countries in eastern and southern Africa. Cases (N=121) included incident HIV-1 transmissions that were established as linked within the serodiscordant partnership by viral sequencing; controls (N=501) were nontransmitting HIV-1-infected partners. Subtype was determined for partial env and gag genes. Multiple logistic regression controlled for age and gender of the HIV-1-nfected partner and self-reported unprotected sex. Plasma and genital HIV-1 RNA concentrations were compared between subtype C and non-C subtypes using generalized estimating equations. Results: HIV-1 subtype C was not associated with increased risk of HIV-1 transmission compared with non-C subtypes: env adjusted odds ratio (adjOR) 1.14 [95% confidence interval (CI) 0.74-1.75, P=0.6] and gag adjOR 0.98 (95% CI 0.63-1.52, P=0.9). Plasma and genital HIV-1 RNA levels did not differ significantly for subtype C versus non-C. Conclusion: In a geographically diverse population of heterosexual African HIV-1 serodiscordant couples, subtype C was not associated with greater risk of HIV-1 transmission compared with non-C subtypes, arguing against the hypothesis that subtype C is more transmissible compared with other common subtypes.

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