Es. Daar et al., Effects of plasma HIV RNA, CD4(+) T lymphocytes, and the chemokine receptors CCR5 and CCR2b on HIV disease progression in hemophiliacs, J ACQ IMM D, 21(4), 1999, pp. 317-325
We have investigated the effects of plasma HIV RNA, CD4(+) T lymphocytes an
d chemokine receptors CCR5 and CCR2b on HIV disease progression in hemophil
iacs. We prospectively observed during follow-up 207 HIV-infected hemophili
acs in the Hemophilia Growth and Development Study. Plasma HIV RNA was meas
ured on cryopreserved plasma from enrollment using the Chiron Corporation b
DNA (version 2.0) assay. Genoytpe variants CCR2b-64I and CCR5-Delta 32 were
detected using standard molecular techniques. Those with the mutant allele
for CCR2b, and to a lesser extent CCR5, had lower plasma HIV RNA, and high
er CD4(+) T lymphocytes than did those without these genetic variants. Afte
r controlling for the effects of plasma HIV RNA and CD4(+) T lymphocytes, t
hose with the CCR2b mutant allele compared with those wild-type, had a tren
d toward a lower risk of progression to AIDS, adjusted relative hazard of 1
.94 (95% confidence interval [CI], 0.9-4.18; p = .092), and AIDS-related de
ath, relative hazard 1.97 (95% CI, 0.98-4.00; p = .059). We conclude that p
lasma HIV RNA, CD4(+) T lymphocytes, and CCR genotypes are correlated, and
the protective affect of CCR2b against HIV disease progression is not compl
etely explained by plasma HIV RNA or CD4(+) T-lymphocyte number.