Natural evolution of CD4+ cell count in patients with CD4 >350 or >500  cells/mm3 at the time of diagnosis according to HIV-1 coreceptor tropism.
The HIV-1 coreceptor usage may play a critical role in AIDS pathogenesis and the X4-using viruses are considered to be more pathogenic than the R5-tropic viruses. These observations may influence the therapeutic decisions by asking for an earlier antiretroviral (ARV) treatment for the patients infected by the X4-tropic viruses compared with those infected by the R5-tropic viruses. The natural evolution of CD4+ cell count for 109 non-treated patients infected by the R5- or X4-tropic HIV-1 viruses with CD4+ >350 and >500 cells/mm(3) at time of diagnosis was compared until the initiation of an ARV regimen. The coreceptor usage was determined from the V3 env region sequence by Geno2Pheno (false positive rate 10%). A mixed linear regression model to analyse the CD4+ data with tropism as fixed effect in the model was used. Overall, 93 (85.3%) and 16 (14.7%) were infected by R5- and X4-tropic viruses, respectively. The median age, baseline CD4+ cell count, and viral load were 34 years (IQR: 30-42), 523 cells/mm(3) (IQR: 420-604), and 4.5 log(10)  copies/ml (IQR: 3.9-5.0), respectively. There was no statistical difference in time to progression between the patients harboring R5- or X4-tropic viruses. The same results were observed for the sub-group of patients with CD4+ cell count >500 cells/mm(3). The virus tropism has no impact on the CD4+ cell count evolution in these HIV-1 patients diagnosed with CD4+ >350 or >500 cells/mm(3) suggesting that the tropism determination at time of diagnosis does not seem to be a useful tool to predict the clinical progression.
UMR S-943, Pierre et Marie Curie University, Paris, France. cathia.soulie@psl.aphp.fr
Cathia
C
Soulié
Charlotte
C
Charpentier
Philippe
P
Flandre
Clément
C
Nino
Guislaine
G
Carcelain
Anne
A
Simon
Christine
C
Katlama
Roland
R
Landman
Françoise
F
Brun-Vézinet
Diane
D
Descamps
Vincent
V
Calvez
Anne-Geneviève
AG
Marcelin
D000328:Adult; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D015658:HIV Infections / Q000175:diagnosis* / Q000821:virology; D015497:HIV-1 / Q000235:genetics / Q000472:pathogenicity; D006801:Humans; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D015728:Receptors, HIV / Q000235:genetics*; D013997:Time Factors; D019562:Viral Load; D056189:Viral Tropism; D054299:env Gene Products, Human Immunodeficiency Virus / Q000235:genetics
D015728:Receptors, HIV; D054299:env Gene Products, Human Immunodeficiency Virus