African descent is associated with slower CD4 cell count decline in treatment-naive patients of the Swiss HIV Cohort Study

V. Müller, Viktor Von Wyl, Sabine Yerly, Jürg Böni, Thomas Klimkait, Philippe Bürgisser, Bruno Ledergerber, Huldrych F. Günthard, Sebastian Bonhoeffer

Research output: Article

23 Citations (Scopus)

Abstract

Objective: We investigated the effect of descent (African versus European) on the progression of untreated HIV infections in a prospective cohort study of HIV-1-infected individuals. Methods: We estimated the linear rate of decline of the CD4 cell count and the setpoint viral load in patients with sufficient data points. The effect of descent was assessed by multivariate regression models including descent, sex, viral subtype, the earliest date of confirmed infection, age, and the baseline CD4 + cell count;the rate of CD4 cell count decline was also analyzed with mixed-effect models and with matched comparisons between patients of African and European descent based on the baseline CD4 cell count. Results: We found that the decline slope of the CD4 cell count was significantly less steep (+26.6 cells/ml per year;95% confidence interval, 12.3-41.0;P> 0.001) in patients of African descent (n = 123) compared with patients of European descent (n = 463), and this effect was independent of differences in the infecting viral subtypes. Matched comparisons confirmed the effect of African descent (P > 0.001). Remarkably, the rate of CD4 cell count decline depended strongly on the viral setpoint in patients of European descent (-46.3 cells/ml per year/log 10 RNA copies/ml;95% confidence interval, -55.8 to -36.7;P> 0.001) but not in patients of African descent. Conclusion: Slower disease progression in patients of African descent might be related to host factors allowing better tolerance of high virus levels in patients of African descent compared with patients of European descent.

Original languageEnglish
Pages (from-to)1269-1276
Number of pages8
JournalAIDS
Volume23
Issue number10
DOIs
Publication statusPublished - jún. 19 2009

Fingerprint

CD4 Lymphocyte Count
Cohort Studies
HIV
Therapeutics
Confidence Intervals
Viral Load
HIV Infections
Disease Progression
HIV-1
Prospective Studies
RNA
Viruses
Infection

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

African descent is associated with slower CD4 cell count decline in treatment-naive patients of the Swiss HIV Cohort Study. / Müller, V.; Von Wyl, Viktor; Yerly, Sabine; Böni, Jürg; Klimkait, Thomas; Bürgisser, Philippe; Ledergerber, Bruno; Günthard, Huldrych F.; Bonhoeffer, Sebastian.

In: AIDS, Vol. 23, No. 10, 19.06.2009, p. 1269-1276.

Research output: Article

Müller, V, Von Wyl, V, Yerly, S, Böni, J, Klimkait, T, Bürgisser, P, Ledergerber, B, Günthard, HF & Bonhoeffer, S 2009, 'African descent is associated with slower CD4 cell count decline in treatment-naive patients of the Swiss HIV Cohort Study', AIDS, vol. 23, no. 10, pp. 1269-1276. https://doi.org/10.1097/QAD.0b013e32832d4096
Müller, V. ; Von Wyl, Viktor ; Yerly, Sabine ; Böni, Jürg ; Klimkait, Thomas ; Bürgisser, Philippe ; Ledergerber, Bruno ; Günthard, Huldrych F. ; Bonhoeffer, Sebastian. / African descent is associated with slower CD4 cell count decline in treatment-naive patients of the Swiss HIV Cohort Study. In: AIDS. 2009 ; Vol. 23, No. 10. pp. 1269-1276.
@article{73df133966314007ba76430b93741fa7,
title = "African descent is associated with slower CD4 cell count decline in treatment-naive patients of the Swiss HIV Cohort Study",
abstract = "Objective: We investigated the effect of descent (African versus European) on the progression of untreated HIV infections in a prospective cohort study of HIV-1-infected individuals. Methods: We estimated the linear rate of decline of the CD4 cell count and the setpoint viral load in patients with sufficient data points. The effect of descent was assessed by multivariate regression models including descent, sex, viral subtype, the earliest date of confirmed infection, age, and the baseline CD4 + cell count;the rate of CD4 cell count decline was also analyzed with mixed-effect models and with matched comparisons between patients of African and European descent based on the baseline CD4 cell count. Results: We found that the decline slope of the CD4 cell count was significantly less steep (+26.6 cells/ml per year;95{\%} confidence interval, 12.3-41.0;P> 0.001) in patients of African descent (n = 123) compared with patients of European descent (n = 463), and this effect was independent of differences in the infecting viral subtypes. Matched comparisons confirmed the effect of African descent (P > 0.001). Remarkably, the rate of CD4 cell count decline depended strongly on the viral setpoint in patients of European descent (-46.3 cells/ml per year/log 10 RNA copies/ml;95{\%} confidence interval, -55.8 to -36.7;P> 0.001) but not in patients of African descent. Conclusion: Slower disease progression in patients of African descent might be related to host factors allowing better tolerance of high virus levels in patients of African descent compared with patients of European descent.",
keywords = "African descent, Disease progression, HIV subtypes, HIV-1, Host factors",
author = "V. M{\"u}ller and {Von Wyl}, Viktor and Sabine Yerly and J{\"u}rg B{\"o}ni and Thomas Klimkait and Philippe B{\"u}rgisser and Bruno Ledergerber and G{\"u}nthard, {Huldrych F.} and Sebastian Bonhoeffer",
year = "2009",
month = "6",
day = "19",
doi = "10.1097/QAD.0b013e32832d4096",
language = "English",
volume = "23",
pages = "1269--1276",
journal = "AIDS",
issn = "0269-9370",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

TY - JOUR

T1 - African descent is associated with slower CD4 cell count decline in treatment-naive patients of the Swiss HIV Cohort Study

AU - Müller, V.

AU - Von Wyl, Viktor

AU - Yerly, Sabine

AU - Böni, Jürg

AU - Klimkait, Thomas

AU - Bürgisser, Philippe

AU - Ledergerber, Bruno

AU - Günthard, Huldrych F.

AU - Bonhoeffer, Sebastian

PY - 2009/6/19

Y1 - 2009/6/19

N2 - Objective: We investigated the effect of descent (African versus European) on the progression of untreated HIV infections in a prospective cohort study of HIV-1-infected individuals. Methods: We estimated the linear rate of decline of the CD4 cell count and the setpoint viral load in patients with sufficient data points. The effect of descent was assessed by multivariate regression models including descent, sex, viral subtype, the earliest date of confirmed infection, age, and the baseline CD4 + cell count;the rate of CD4 cell count decline was also analyzed with mixed-effect models and with matched comparisons between patients of African and European descent based on the baseline CD4 cell count. Results: We found that the decline slope of the CD4 cell count was significantly less steep (+26.6 cells/ml per year;95% confidence interval, 12.3-41.0;P> 0.001) in patients of African descent (n = 123) compared with patients of European descent (n = 463), and this effect was independent of differences in the infecting viral subtypes. Matched comparisons confirmed the effect of African descent (P > 0.001). Remarkably, the rate of CD4 cell count decline depended strongly on the viral setpoint in patients of European descent (-46.3 cells/ml per year/log 10 RNA copies/ml;95% confidence interval, -55.8 to -36.7;P> 0.001) but not in patients of African descent. Conclusion: Slower disease progression in patients of African descent might be related to host factors allowing better tolerance of high virus levels in patients of African descent compared with patients of European descent.

AB - Objective: We investigated the effect of descent (African versus European) on the progression of untreated HIV infections in a prospective cohort study of HIV-1-infected individuals. Methods: We estimated the linear rate of decline of the CD4 cell count and the setpoint viral load in patients with sufficient data points. The effect of descent was assessed by multivariate regression models including descent, sex, viral subtype, the earliest date of confirmed infection, age, and the baseline CD4 + cell count;the rate of CD4 cell count decline was also analyzed with mixed-effect models and with matched comparisons between patients of African and European descent based on the baseline CD4 cell count. Results: We found that the decline slope of the CD4 cell count was significantly less steep (+26.6 cells/ml per year;95% confidence interval, 12.3-41.0;P> 0.001) in patients of African descent (n = 123) compared with patients of European descent (n = 463), and this effect was independent of differences in the infecting viral subtypes. Matched comparisons confirmed the effect of African descent (P > 0.001). Remarkably, the rate of CD4 cell count decline depended strongly on the viral setpoint in patients of European descent (-46.3 cells/ml per year/log 10 RNA copies/ml;95% confidence interval, -55.8 to -36.7;P> 0.001) but not in patients of African descent. Conclusion: Slower disease progression in patients of African descent might be related to host factors allowing better tolerance of high virus levels in patients of African descent compared with patients of European descent.

KW - African descent

KW - Disease progression

KW - HIV subtypes

KW - HIV-1

KW - Host factors

UR - http://www.scopus.com/inward/record.url?scp=67651092167&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67651092167&partnerID=8YFLogxK

U2 - 10.1097/QAD.0b013e32832d4096

DO - 10.1097/QAD.0b013e32832d4096

M3 - Article

C2 - 19461503

AN - SCOPUS:67651092167

VL - 23

SP - 1269

EP - 1276

JO - AIDS

JF - AIDS

SN - 0269-9370

IS - 10

ER -