Impact of HIV-1 subtype on CD4 count at HIV seroconversion, rate of decline, and viral load set point in European seroconverter cohorts

Touloumi, Giota, Pantazis, Nikos, Pillay, Deenan, Paraskevis, Dimitrios, Chaix, Marie-Laure, Bucher, Heiner C, Kücherer, Claudia, Zangerle, Robert, Kran, Anne-Marte Bakken, Porter, Kholoud, Fisher, Martin and The CASCADE collaboration in EuroCoord, (2013) Impact of HIV-1 subtype on CD4 count at HIV seroconversion, rate of decline, and viral load set point in European seroconverter cohorts. Clinical Infectious Diseases, 56 (6). pp. 888-897. ISSN 1537-6591

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Abstract

BACKGROUND

Human immunodeficiency virus type 1 (HIV-1) subtype may influence disease progression. We compared CD4 lymphocyte cell count levels at seroconversion, decline rates and viral load set point in individuals infected with different HIV-1 subtypes.

METHODS

We used data from the Concerted Action on SeroConversion to AIDS and Death in Europe (CASCADE) collaboration, restricted to those infected since 1996, aged ≥15 years, and applied mixed effects models for CD4 cell count decline and median regression for viral load set point (mean level 6-24 months from seroconversion).

RESULTS

The analysis included 3364 seroconverters with known HIV-1 subtypes. Compared with subtype B, CD4 at seroconversion was significantly higher for subtype CRF01 and lower for subtype C. Subsequent CD4 decline was significantly slower for subtypes A and CRF02 and marginally slower for subtype C compared with B. Mean CD4 loss at 2 years of seroconversion for white men exposed through sex between men, aged 30-39 years, having seroconverted since 2006, enrolled within 6 months of seroconversion, and without acute infection was 88, 142, 100, 130, 103, and 167 cells/µL for subtypes A, B, C, CRF01_AE, CRF02_AG, and G, respectively. In adjusted analysis, median viral load set point and time to clinical AIDS/death did not differ significantly by subtype, although all subtypes, except C, tended to have lower levels compared with B.

CONCLUSIONS

HIV-1 subtype significantly influences seroconversion CD4 cell levels and decline rates but not viral load set point. These findings may be helpful to HIV-positive individuals and their attending physicians in understanding disease progression.

Item Type: Article
Additional Information: Martin Fisher is not listed on the main author citation list but forms part of the CASCADE collaboration in EuroCoord
Schools and Departments: Brighton and Sussex Medical School > Brighton and Sussex Medical School
Subjects: R Medicine > RC Internal medicine > RC0109 Infectious and parasitic diseases
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Depositing User: Ellen Thomas
Date Deposited: 12 Aug 2013 08:10
Last Modified: 12 Aug 2013 08:10
URI: http://srodev.sussex.ac.uk/id/eprint/45875
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