PLoS ONE (Jan 2012)

HIV-1 clade D is associated with increased rates of CD4 decline in a Kenyan cohort.

  • Lyle R McKinnon,
  • Nico J Nagelkerke,
  • Rupert Kaul,
  • Souradet Y Shaw,
  • Rupert Capina,
  • Ma Luo,
  • Anthony Kariri,
  • Winnie Apidi,
  • Makobu Kimani,
  • Charles Wachihi,
  • Walter Jaoko,
  • A Omu Anzala,
  • Joshua Kimani,
  • T Blake Ball,
  • Francis A Plummer

DOI
https://doi.org/10.1371/journal.pone.0049797
Journal volume & issue
Vol. 7, no. 11
p. e49797

Abstract

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HIV-1 is grouped phylogenetically into clades, which may impact rates of HIV-1 disease progression. Clade D infection in particular has been shown to be more pathogenic. Here we confirm in a Nairobi-based prospective female sex worker cohort (1985-2004) that Clade D (n = 54) is associated with a more rapid CD4 decline than clade A1 (n = 150, 20.6% vs 13.4% decline per year, 1.53-fold increase, p = 0.015). This was independent of "protective" HLA and country of origin (p = 0.053), which in turn were also independent predictors of the rate of CD4 decline (p = 0.026 and 0.005, respectively). These data confirm that clade D is more pathogenic than clade A1. The precise reason for this difference is currently unclear, and requires further study. This is first study to demonstrate difference in HIV-1 disease progression between clades while controlling for protective HLA alleles.