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

Touloumi G, Pantazis N, Pillay D, Paraskevis D, Chaix ML, Bucher HC, Kücherer C et al.; on behalf of the CASCADE collaboration in EuroCoord (for Germany Hamouda O) (2012): Impact of HIV-1 subtype on CD4 count at HIV seroconversion, rate of decline and viral load set point in European seroconverter cohorts.
Clin. Infect. Dis.: Epub Dec 7. doi: 10.1093/cid/cis1000.

Background: Whether HIV-1 subtype influences disease progression remains unclear. We compared CD4 levels at seroconversion, rates of decline and viral load set-point in individuals infected with different HIV-1 subtypes.

Methods: We used data from CASCADE restricted to those infected since 1996, aged ≥15 years and applied mixed effects models for CD4 cell decline and median regression for viral load set-point (mean level 6-24 months from seroconversion).

Results: 3,364 seroconverters with known HIV-1 subtypes were included in the analysis. Compared to subtype B, CD4 at seroconversion was significantly higher for CRF01 and lower for C compared to B. Subsequent CD4 decline was significantly slower for A and CRF02 and marginally slower for C compared to B. As an example, mean CD4 loss at 2 years of seroconversion for white men exposed through sex between men, aged 30-39, seroconverted since 2006, enrolled within 6 months of seroconversion, 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 there was a tendency for all subtypes, except C, to have lower levels compared to B.

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

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