Literature DB >> 20010433

HIV-1 viral subtype differences in the rate of CD4+ T-cell decline among HIV seroincident antiretroviral naive persons in Rakai district, Uganda.

Noah Kiwanuka1, Merlin Robb, Oliver Laeyendecker, Godfrey Kigozi, Fred Wabwire-Mangen, Fredrick E Makumbi, Fred Nalugoda, Joseph Kagaayi, Michael Eller, Leigh Anne Eller, David Serwadda, Nelson K Sewankambo, Steven J Reynolds, Thomas C Quinn, Ronald H Gray, Maria J Wawer, Christopher C Whalen.   

Abstract

BACKGROUND: Data on the effect of HIV-1 viral subtype on CD4 T-cell decline are limited.
METHODS: We assessed the rate of CD4 T-cell decline per year among 312 HIV seroincident persons infected with different HIV-1 subtypes. Rates of CD4 decline by HIV-1 subtype were determined by linear mixed effects models, using an unstructured convariance structure.
RESULTS: A total of 59.6% had D, 15.7% A, 18.9% recombinant viruses (R), and 5.8% multiple subtypes (M). For all subtypes combined, the overall rate of CD4 T-cell decline was -34.5 [95% confidence interval (CI), -47.1, -22.0] cells/ microL per yr, adjusted for age, sex, baseline CD4 counts, and viral load. Compared with subtype A, the adjusted rate of CD4 cell loss was -73.7/microL/yr (95% CI, -113.5, -33.8, P < 0.001) for subtype D, -43.2/microL/yr (95% CI, -90.2, 3.8, P = 0.072) for recombinants, and -63.9/microL/yr (95% CI, -132.3, 4.4, P = 0.067) for infection with multiple HIV subtypes. Square-root transformation of CD4 cell counts did not change the results.
CONCLUSIONS: Infection with subtype D is associated with significantly faster rates of CD4 T-cell loss than subtype A. This may explain the more rapid disease progression for subtype D compared with subtype A.

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Year:  2010        PMID: 20010433      PMCID: PMC2877752          DOI: 10.1097/QAI.0b013e3181c98fc0

Source DB:  PubMed          Journal:  J Acquir Immune Defic Syndr        ISSN: 1525-4135            Impact factor:   3.731


  25 in total

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