HIV-1 viral subtype differences in the rate of CD4+ T-Cell decline among HIV seroincident antiretroviral naive persons in rakai district, Uganda

Noah Kiwanuka, Merlin Robb, Oliver Laeyendecker, Godfrey Kigozi, Fred Wabwire-Mangen, Fredrick E. Makumbi, Fred Nalugoda, Joseph Kagaayi, Michael Eller, Leigh Anne Eller, David Serwadda, Nelson K. Sewankambo, Steven J. Reynolds, Thomas C. Quinn, Ronald H. Gray, Maria J. Wawer, Christopher C. Whalen

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Data on the effect of HIV-1 viral subtype on CD4 T-cell decline are limited. METHODS: We assessed the rate of CD4 T-cell decline per year among 312 HIV seroincident persons infected with different HIV-1 subtypes. Rates of CD4 decline by HIV-1 subtype were determined by linear mixed effects models, using an unstructured convariance structure. RESULTS: A total of 59.6% had D, 15.7% A, 18.9% recombinant viruses (R), and 5.8% multiple subtypes (M). For all subtypes combined, the overall rate of CD4 T-cell decline was-34.5 [95% confidence interval (CI),-47.1,-22.0] cells/μL per yr, adjusted for age, sex, baseline CD4 counts, and viral load. Compared with subtype A, the adjusted rate of CD4 cell loss was-73.7/μL/yr (95% CI,-113.5,-33.8, P < 0.001) for subtype D,-43.2/μL/yr (95% CI,-90.2, 3.8, P = 0.072) for recombinants, and-63.9/μL/yr (95% CI,-132.3, 4.4, P = 0.067) for infection with multiple HIV subtypes. Square-root transformation of CD4 cell counts did not change the results. CONCLUSIONS: Infection with subtype D is associated with significantly faster rates of CD4 T-cell loss than subtype A. This may explain the more rapid disease progression for subtype D compared with subtype A.

Original languageEnglish (US)
Pages (from-to)180-184
Number of pages5
JournalJournal of Acquired Immune Deficiency Syndromes
Issue number2
StatePublished - Jun 1 2010


  • Cell decline
  • HIV disease progression
  • HIV-1 subtypes
  • Rate of CD41

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)


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