title: African ethnicity can influence immunological responses to highly active antiretroviral therapy and immunological success at 48 months: a retrospective pilot study.
abstract: OBJECTIVE
  To assess whether African ethnicity is independently associated with a poorer CD4 reconstitution with highly active antiretroviral therapy (HAART) compared to Caucasian ethnicity.
  
  
  METHODS
  We conducted a retrospective epidemiological study among 575 HIV-1-positive patients at our center and defined immunological success as the presence of blood CD4 lymphocyte counts>500 cells/mm3 in more than 50% of the values collected from 6 to 48 months after beginning HAART. Patients displaying an HIV-1 viral load>200 copies/ml or more than one HIV-1 viral load between 20 and 200 copies/ml during follow-up, were excluded. Patients with baseline blood CD4 counts>500 cells/mm3 were also excluded.
  
  
  RESULTS
  Two hundred and eighty patients met the inclusion criteria and no exclusion criteria. After 48 months of HAART, blood CD4 lymphocyte counts were lower in Africans than in Caucasians: 449 (65-975) vs. 569 (131-1698) cells/mm3 (p=0.02). Immunological success was present in 142/220 (64.5%) Caucasians vs. 29/60 (48.3%) Africans (p=0.02). African ethnicity was independently associated with the absence of immunological success (odds ratio 2.22, 95% confidence interval 1.097-4.504; p=0.02) despite similar baseline blood CD4 counts (219 vs. 204 cells/mm3, p=0.72).
  
  
  CONCLUSIONS
  Our findings suggest that African ethnicity is independently associated with a poorer CD4 reconstitution during HAART than Caucasian ethnicity.
authors.affiliation: Service de Médecine Interne, Maladies Infectieuses et Immunologie Clinique, Hôpital Robert Debré, CHU Reims, Avenue Général Koenig, 51100 Reims, France.
authors.forename: Christelle
authors.initials: C
authors.lastname: Guillaume
authors.forename: Yohan
authors.initials: Y
authors.lastname: N'Guyen
authors.forename: Véronique
authors.initials: V
authors.lastname: Brodard
authors.forename: Firouze
authors.initials: F
authors.lastname: Bani-Sadr
authors.forename: Roland
authors.initials: R
authors.lastname: Jaussaud
authors.forename: Laurent
authors.initials: L
authors.lastname: Andreoletti
mesh_terms: D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active; D044383:Black People; D018791:CD4 Lymphocyte Count; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000276:immunology*; D015497:HIV-1 / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load; D044465:White People; D055815:Young Adult
keywords: African patient; CD4 recovery; Ethnicity; HAART; HIV