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Impact of HIV-1 Subtype on CD4 Count at HIV Seroconversion, Rate of Decline, and Viral Load Set Point in European Seroconverter Cohorts

2012; Oxford University Press; Volume: 56; Issue: 6 Linguagem: Inglês

10.1093/cid/cis1000

1537-6591

Giota Touloumi, Nikos Pantazis, Deenan Pillay, Dimitrios Paraskevis, Marie‐Laure Chaix, Heiner C. Bucher, Claudia Kücherer, Robert Zangerle, Anne Marte Bakken Kran, Kholoud Porter, Robert Zangerle, Anthony D. Kelleher, David A. Cooper, Pat Grey, Robert Finlayson, Mark Bloch, T. Kelleher, Tim Ramacciotti, Linda Gelgor, David A. Cooper, Don Smith, J. Gill, Louise B. Jørgensen, Irja Lutsar, Geneviève Chêne, F Dabis, Rodolphe Thiébaut, Bernard Masquelier, D. Costagliola, Marguerite Guiguet, P. Vanhems, Marie‐Laure Chaix, Jade Ghosn, C. Goujard, Laurence Meyer, Faroudy Boufassa, Osamah Hamouda, Claudia Kücherer, Barbara Bartmeyer, Giota Touloumi, Nikos Pantazis, Όλγα Κατσαρού, Vassilios Paparizos, Panagiotis Gargalianos‐Kakolyris, Marios Lazanas, G Rezza, Maria Dorrucci, Antonella d’Arminio Monforte, Andrea De Luca, Maria Prins, Ronald B. Geskus, Jannie J. van der Helm, Hanneke Schuitemaker, Mette Sannes, Oddbjørn Brubakk, Anne Marte Bakken Kran, Magdalena Rosińska, Roberto Muga, Jordi Tor, Patricia García de Olalla, Joan A. Caylà, Julia del Amo, Santiago Moreno, Susana Monge, Julia del Amo, Jorge del Romero, Santiago Pérez‐Hoyos, Heiner C. Bucher, Martin Rickenbach, P Francioli, Ruslan Malyuta, R.P. Brettle, Gary Murphy, Caroline Sabin, Kholoud Porter, Margaret Johnson, Andrew Phillips, Abdel Babiker, Valérie Delpech, Deenan Pillay,

HIV/AIDS drug development and treatment

Human immunodeficiency virus type 1 (HIV-1) subtype may influence disease progression. We compared CD4 lymphocyte cell count levels at seroconversion, decline rates and viral load set point in individuals infected with different HIV-1 subtypes.We used data from the Concerted Action on SeroConversion to AIDS and Death in Europe (CASCADE) collaboration, restricted to those infected since 1996, aged ≥15 years, and applied mixed effects models for CD4 cell count decline and median regression for viral load set point (mean level 6-24 months from seroconversion).The analysis included 3364 seroconverters with known HIV-1 subtypes. Compared with subtype B, CD4 at seroconversion was significantly higher for subtype CRF01 and lower for subtype C. Subsequent CD4 decline was significantly slower for subtypes A and CRF02 and marginally slower for subtype C compared with B. Mean CD4 loss at 2 years of seroconversion for white men exposed through sex between men, aged 30-39 years, having seroconverted since 2006, enrolled within 6 months of seroconversion, and without acute infection was 88, 142, 100, 130, 103, and 167 cells/µL for subtypes A, B, C, CRF01_AE, CRF02_AG, and G, respectively. In adjusted analysis, median viral load set point and time to clinical AIDS/death did not differ significantly by subtype, although all subtypes, except C, tended to have lower levels compared with B.HIV-1 subtype significantly influences seroconversion CD4 cell levels and decline rates but not viral load set point. These findings may be helpful to HIV-positive individuals and their attending physicians in understanding disease progression.