Increasing clinical virulence in two decades of the Italian HIV epidemic.

摘要: The recent origin and great evolutionary potential of HIV imply that the virulence virus might still be changing, which could greatly affect future pandemic. However, previous studies time trends have yielded conflicting results. Here we used an established methodology to assess in severity (virulence) untreated infections a large Italian cohort. We characterized clinical by decline slope CD4 count (n = 1423 patients) viral setpoint 785 patients with sufficient data points. linear regression models detect correlations between date diagnosis (ranging 1984–2006) markers, controlling for gender, exposure category, age, at entry. displayed highly significant correlation pointing direction increasing virulence. A detailed analysis riskgroups revealed epidemics intravenous drug users started apparently less virulent virus, but experienced strongest trend towards steeper among major categories. While our study did not allow us exclude effect host factors, findings are consistent hypothesis Importantly, use allowed comparison earlier results, confirmed genuine differences exist different epidemics. thus conclude there is single global virulence, results obtained one epidemic cannot extrapolated others. Comparison discordant patterns hints converging trend, indicate optimal level virus.