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Aggressive HIV strain identified in Cuba
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Researchers have observed a recombinant variant of HIV among patients in Cuba that appears to be significantly more aggressive than other forms of HIV.
According to the researchers from KU Leuven Laboratory for Clinical and Epidemiological Virology, in Belgium, patients with this strain, CRF19_cpx, progress to AIDS within 3 years of infection. It is the result of an early switch from the CCR5 co-receptor as an anchor point to CXCR4 co-receptor.
“CRF19_cpx is a genetic form hitherto only reported in Cuba, but with evidenced central African ancestry,” the researchers wrote in EBioMedicine. “Clinicians in Cuba noted an increasing trend of rapid progression to AIDS (<3 years since seroconversion). We propose that this increase is at least in part due to the spread of CRF19_cpx, which we found exclusively associated with rapid progression to AIDS, whereas for other subtypes and CRFs, the disease progression was distributed as is generally seen in other parts of the world.”
Anne-Mieke Vandamme, PhD, and colleagues evaluated blood from 73 patients who were recently infected with HIV: 52 at AIDS diagnosis and 21 without AIDS. They compared it with blood from 22 patients who progressed to AIDS after a normal period of HIV. The researchers analyzed differences in the subtypes between patients.
They found that all patients with the recombinant CRF19_cpx virus were in the group with rapid AIDS progression. The CRF19_cpx subtype, oral candidiasis and RANTES levels were strong predictors of rapid progression. RANTES binds to CCR5, and the high level of RANTES indicates that CCR5 receptors were not available for HIV to bind, leading it to bind to the CXCR4 co-receptors. The virus typically switches over in the later years of the infection.
When investigating the recombinant virus, the researchers found fragments of it contain a protease from subtype D that allows the virus to replicate in greater numbers.
“We propose that an evolutionary very fit CRF10_cpx together with coinfections are linked to the increase of rapid progression to AIDS in newly infected patients in Cuba,” the researchers wrote. “The robust and significant association with a fitter protease, more circulating virus, higher immune activation and CXCR4 co-receptor use suggests CRF19_cpx may be a more pathogenic virus.”
Disclosure: The researchers report no relevant financial disclosures.
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