Slow progression of HIV-1 infection in a cohort of antiretroviral naïve hotel workers in Dar es Salaam, Tanzania as defined by their CD4 cell slopes.
Data on slow progression following HIV-1 infection in Africa are sparse. From a study on the natural history of HIV-1 infection in Dar es Salaam, Tanzania, an analysis of immunological and clinical data from 237 HIV-1 seropositive individuals was performed. Annual CD4 cell determinations were carried out by flow cytometry. None was on antiretroviral treatment. CD4+ cell slopes were obtained by fitting a linear regression model. A study population of 50 individuals with >3 CD4 cell determinations and followed for >5 y had a mean follow-up of 72.7 months, and mean 5.7 CD4+ cell determinations. With a criterion of maintaining a CD4 cell count >or=500 cells/ml, 8 of the 50 (16.0%) were long-term non-progressors (LTNP). With a definition of maintaining a CD4+ cell slope <or=-10 (a loss of 10 or less cells per y), 13 (26.0%) were long-term slow progressors (LTSP). 11 of them (84.6%) had a baseline CD4 cell count <500 cells/microl and 5(38.5%) had a baseline CD4 cell count less than 350 cells/microl. An analysis of the selection bias introduced during slope determination is presented. With no selection, 24 (23.3%) would have documented slow CD4 progression among those enrolled for 5 or more y regardless of CD4 determinations.
Bakari
Muhammad
M
Department of Internal Medicine, Muhimbili University College of Health Sciences (MUCHS), P.O. Box 65001, Dar es Salaam,Tanzania. mbakari@muchs.ac.tz
Urassa
Willy
W
Mhalu
Fred
F
Biberfeld
Gunnel
G
Pallangyo
Kisali
K
Sandström
Eric
E
D000328:Adult; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D015658:HIV Infections / Q000276:immunology* / Q000503:physiopathology / Q000821:virology; D020276:HIV Long-Term Survivors; D015497:HIV-1 / Q000302:isolation & purification*; D006801:Humans; D016014:Linear Models; D008297:Male; D013636:Tanzania / Q000453:epidemiology