Shorter survival of SDF1-3 ' Al3 ' A homozygotes linked to CD4(+) T cell decrease in advanced human immunodeficiency virus type I infection

The SDF-1 3'A allelic polymorphism has been reported to influence either po sitively or negatively the progression of human immunodeficiency virus type 1 (HIV-1) disease. Therefore, the SDF-1 genotype of 729 HIV-1-infected ind ividuals pooled from 3 distinct cohorts was determined. A statistically non significant association between the SDF1-3'Al3'A genotype and accelerated d isease progression was evident among seroconverters (n = 319), but a striki ng correlation of decreased survival after either diagnosis of AIDS accordi ng to the 1993 definition or loss of CD4(+) T cell counts <200 was observed . The relative hazards for SDF1-3'Al 3'A homozygotes, compared with heteroz ygotes and wild-type homozygotes were 2.16 (P = .0047), for time from diagn osis according to the 1993 Centers for Disease Control and Prevention AIDS case definition (AIDS-'93) to death, and 3.43 (P = .0001), for time from CD 4(+) T cells <200 to death, Because no difference in survival was observed after diagnosis according to AIDS-'87, the association of the SDF1-3'A/3'A genotype with the accelerated progression of late-stage HIV-1 disease appea rs to be explained for the most part by the loss of CD4(+) T lymphocytes.