%0 Journal Article
%T Chemokine co-receptor usage in HIV-1-infected treatment-na£¿ve voluntary counselling and testing clients in Southern Taiwan
%A Hung-Chin Tsai
%A Pei-Yun Chou
%A Shue-Ren Wann
%A Susan Shin-Jung Lee
%A Yao-Shen Chen
%J -
%D 2015
%R 10.1136/bmjopen-2014-007334
%X Objective The goal of this present study was to determine the proportion of CCR5-tropic and CXCR4-tropic viruses and impact of tropism test on clinical presentation, CD4 cell counts, viral load and genotypic drug resistance from drug-na£¿ve, voluntary counselling and testing (VCT) clients in southern Taiwan.

Design This was a cross-sectional study. Plasma samples were collected from HIV-1-infected patients from January 2013 to December 2013; subjects were recruited from free VCT centres in southern Taiwan.

Setting Taiwan.

Participants Plasma samples from 108 HIV-1-infected, treatment-na£¿ve, VCT clients were analysed. HIV-1 strains were sequenced, genotype resistance was determined by a commercial kit (Viro-seq) and co-receptor tropism (CRT) was predicted by an internet tool geno2pheno[coreceptor], with a 10% false-positive rate as the cut-off. Differences in progression markers, patient characteristics, VCT questionnaires and HIV subtype distribution were evaluated statistically.

Results All the 108 VCT clients were male with 90% between the ages of 20 and 40£¿years. Eighty-eight per cent of the patients were men who have sex with men (MSM). The median (IQR) CD4 cell count was 342 cells/¦ÌL (221¨C454) and the viral load was 4.6 log (4.0¨C5.0). HIV-transmitted drug resistance was found in 9.3% (10/108) of the patients. CRT predictions indicated that 74% of the patients had only R5-tropic strains. CRT was not associated with CD4 cell counts, patient characteristics, VCT questionnaire and transmitted drug resistance. There was a significant difference with regard to viral load at the time of presentation, showing that patients with R5 more often had a higher viral load as compared with those with X4/DM strains (4.6¡À0.6 log vs 4.33¡À0.7 log, p=0.036).

Conclusions We found that 74% of the VCT clients were infected with R5-tropic virus strains. HIV-transmitted drug resistance was not associated with CRT predictions. Higher viral load at presentation was predictive of R5 co-receptor usage
%U https://bmjopen.bmj.com/content/5/4/e007334