TY - JOUR
T1 - HIV-1 viral subtype differences in the rate of CD4+ T-Cell decline among HIV seroincident antiretroviral naive persons in rakai district, Uganda
AU - Kiwanuka, Noah
AU - Robb, Merlin
AU - Laeyendecker, Oliver
AU - Kigozi, Godfrey
AU - Wabwire-Mangen, Fred
AU - Makumbi, Fredrick E.
AU - Nalugoda, Fred
AU - Kagaayi, Joseph
AU - Eller, Michael
AU - Eller, Leigh Anne
AU - Serwadda, David
AU - Sewankambo, Nelson K.
AU - Reynolds, Steven J.
AU - Quinn, Thomas C.
AU - Gray, Ronald H.
AU - Wawer, Maria J.
AU - Whalen, Christopher C.
N1 - Copyright:
Copyright 2010 Elsevier B.V., All rights reserved.
PY - 2010/6/1
Y1 - 2010/6/1
N2 - 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/μL 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/μL/yr (95% CI,-113.5,-33.8, P < 0.001) for subtype D,-43.2/μL/yr (95% CI,-90.2, 3.8, P = 0.072) for recombinants, and-63.9/μL/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.
AB - 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/μL 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/μL/yr (95% CI,-113.5,-33.8, P < 0.001) for subtype D,-43.2/μL/yr (95% CI,-90.2, 3.8, P = 0.072) for recombinants, and-63.9/μL/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.
KW - Cell decline
KW - HIV disease progression
KW - HIV-1 subtypes
KW - Rate of CD41
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U2 - 10.1097/QAI.0b013e3181c98fc0
DO - 10.1097/QAI.0b013e3181c98fc0
M3 - Article
C2 - 20010433
AN - SCOPUS:77953062237
SN - 1525-4135
VL - 54
SP - 180
EP - 184
JO - Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology
JF - Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology
IS - 2
ER -