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Abstract
EFFECT OF HIV-1 RNA LEVELS, CD4+LYMPHOCYTES AND CHEMOKINE RECEPTOR GENE POLYMORPHISMS ON THE RESPONSE TO HAART IN HIV-1 INFECTED CHILDREN
BOLOGNA R, MANGANO A, MECIKOVSKY D, BATTALLA M, SARKIS C, KOPKA J, SEN L
Background: Plasma HIV-1 viral load (pVL) and CD4+ lymphocytes are independent predictors of disease progression in children with HIV-1 infection. Host genetic factors may modify the clinical outcome to AIDS. In a previous study we observed a delay to AIDS progression among children carrying the CCR2-64I allele.
Objective: To examine the effect of baseline pVL level, CD4+ percentage and host genetic polymorphisms of CCR2 and CCR5 on the response to HAART.
Methods: HIV-1 infected children treated for 48 weeks with an open label treatment that included a protease inhibitor were analyzed. pVL levels and CD4+ cells were measure at 12 weeks intervals. Genotyping for chemokine receptors polymorphisms (CCR5-D32 and CCR2-64I) was performed. We compared the frequency of response to HAART according to the host genotype. Response was defined as pVL below LOQ or > 1log reduction from baseline or improvement in CD4+ percentage at week 48 of therapy.
Results: Among 239 HIV-1 infected children the pVL dropped from (x+ SE) 4.7 + 1.2 log to 3.6 + 1.1 (p<0.0001). The baseline pVL differed significantly in those patients with response vs non-responders (4.2+1.5 vs 4.9+0.9 log, respectively; p<0.0004). The baseline CD4+ percentage (x+ SE) was 26.7 + 10.9 in responders vs 17.1+12 in non-responders (p<0.000015). At the study entry, pVL level and CD4+ percentage did not differ significantly by host genotypes.
Eighty-three percent of the children bearing the CCR2-64I allele were good responders compared to 65% of the children carrying the CCR2 wild type genotype (p<0.024). No different response was observed in children carrying the CCR5-D32 mutation.
Conclusions: In HIV-1 infected children baseline pVL level and CD4+ lymphocytes can predict the response to HAART. Those children carrying the CCR2-64I allele have a higher likelihood of response to HAART at 1 year of therapy.
The 1st. IAS Conference on HIV Pathogenesis and Treatment
Abstract no.
132
Suggested Citation
"BOLOGNAR, et al.
EFFECT OF HIV-1 RNA LEVELS, CD4+LYMPHOCYTES AND CHEMOKINE RECEPTOR GENE POLYMORPHISMS ON THE RESPONSE TO HAART IN HIV-1 INFECTED CHILDREN.
Oral Presentation:
The 1st. IAS Conference on HIV Pathogenesis and Treatment
:
Abstract no.
132"
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