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- Title
Viral tropism by geno2pheno as a tool for predicting CD4 decrease in HIV-1-infected naive patients with high CD4 counts.
- Authors
Nozza, Silvia; Canducci, Filippo; Galli, Laura; Cozzi-Lepri, Alessandro; Capobianchi, Maria Rosaria; Ceresola, Elisa Rita; Narciso, Pasquale; Libertone, Raffaella; Castelli, Paula; Moioli, Mariacristina; D'Arminio Monforte, Antonella; Castagna, Antonella
- Abstract
Objectives To investigate the value of tropism (determined by genotypic testing) to predict CD4 depletion in HIV-infected antiretroviral-naive patients with high CD4 counts. Methods Viral tropism was determined by geno2pheno (false positive rate = 10%) in 223 HIV-infected subjects naive to antiretrovirals with CD4 count ≥350 cells/μL and HIV-RNA >500 copies/mL enrolled in the ICONA Foundation Study for whom a stored plasma sample (baseline) was retrospectively tested. We monitored CD4 cell count and identified predictors of decline before antiretroviral therapy initiation, applying a mixed linear model with covariates (age, gender, tropism, HIV risk factor, calendar year of HIV infection, months from HIV diagnosis to baseline, hepatitis C virus status, CD4 and HIV-RNA at sample collection and duration of follow-up). Results Two hundred and twenty-three subjects met the eligibility criteria; 137 (61%) were male and the median age was 35 (31–40) years. Median follow-up was 16.4 (3.2–37.2) months. Median CD4 decrease during follow-up was −157 (−278 to −13) cells/μL. At baseline, 192 (86%) subjects were defined as harbouring R5 virus and 31 (14%) non-R5. Median CD4 count was 571 (458–729) cells/μL and median HIV-RNA was 4.08 (3.57–4.55) log10 copies/mL. At multivariable analysis, a greater mean CD4 decrease was associated with non-R5 viral tropism (−159.9 ± 12.22, P = 0.0002) at baseline. Other significant covariates were female gender, older age, intravenous drug use, longer duration of follow-up, and higher CD4 cell count and higher HIV-RNA at sample collection. Conclusions In patients with CD4 counts ≥350 cells/μL, non-R5 viral tropism by geno2pheno is predictive of CD4 decrease independent of their viral set point and CD4 counts.
- Subjects
HIV-positive persons; ANTIRETROVIRAL agents; HEPATITIS C virus; HIV infections; THERAPEUTICS
- Publication
Journal of Antimicrobial Chemotherapy (JAC), 2012, Vol 67, Issue 5, p1224
- ISSN
0305-7453
- Publication type
Article