title: HIV-1 clade D is associated with increased rates of CD4 decline in a Kenyan cohort.
abstract: HIV-1 is grouped phylogenetically into clades, which may impact rates of HIV-1 disease progression. Clade D infection in particular has been shown to be more pathogenic. Here we confirm in a Nairobi-based prospective female sex worker cohort (1985-2004) that Clade D (n = 54) is associated with a more rapid CD4 decline than clade A1 (n = 150, 20.6% vs 13.4% decline per year, 1.53-fold increase, p = 0.015). This was independent of "protective" HLA and country of origin (p = 0.053), which in turn were also independent predictors of the rate of CD4 decline (p = 0.026 and 0.005, respectively). These data confirm that clade D is more pathogenic than clade A1. The precise reason for this difference is currently unclear, and requires further study. This is first study to demonstrate difference in HIV-1 disease progression between clades while controlling for protective HLA alleles.
authors.affiliation: Department of Medicine, University of Toronto, Toronto, Canada. sijuisijali@gmail.com
authors.forename: Lyle R
authors.initials: LR
authors.lastname: McKinnon
authors.forename: Nico J
authors.initials: NJ
authors.lastname: Nagelkerke
authors.forename: Rupert
authors.initials: R
authors.lastname: Kaul
authors.forename: Souradet Y
authors.initials: SY
authors.lastname: Shaw
authors.forename: Rupert
authors.initials: R
authors.lastname: Capina
authors.forename: Ma
authors.initials: M
authors.lastname: Luo
authors.forename: Anthony
authors.initials: A
authors.lastname: Kariri
authors.forename: Winnie
authors.initials: W
authors.lastname: Apidi
authors.forename: Makobu
authors.initials: M
authors.lastname: Kimani
authors.forename: Charles
authors.initials: C
authors.lastname: Wachihi
authors.forename: Walter
authors.initials: W
authors.lastname: Jaoko
authors.forename: A Omu
authors.initials: AO
authors.lastname: Anzala
authors.forename: Joshua
authors.initials: J
authors.lastname: Kimani
authors.forename: T Blake
authors.initials: TB
authors.lastname: Ball
authors.forename: Francis A
authors.initials: FA
authors.lastname: Plummer
mesh_terms: D000328:Adult; D000483:Alleles; D044383:Black People; D015704:CD4 Antigens / Q000235:genetics / Q000276:immunology; D018450:Disease Progression; D019143:Evolution, Molecular; D005260:Female; D015658:HIV Infections / Q000235:genetics / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000235:genetics / Q000472:pathogenicity; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology; D006801:Humans; D007630:Kenya; D010802:Phylogeny; D060386:Sex Workers
chemical_list: D015704:CD4 Antigens; D006680:HLA Antigens