Correlations between HIV-1 subtypes and changes in CD4+ T cell count over time

Objective To understand the correlations between HIV-1 subtypes and changes in CD4+ T cell count over time in patients with different subtypes of HIV-1 infection. Methods A total of 94 patients who were diagnosed with HIV-1 infection in Nanjing and received at least twice CD4+ T cell counting test before antiretroviral therapy (ART) were recruited in this study. Descriptive analysis was used to present the rates of CD4+ T cell decline for different HIV-1 subtypes. Logistic regression analysis and nonparametric test were conducted to investigate the factors responsible for CD4+ T cell decline and to analyze the correlations between the rates of CD4+ T cell decline and HIV-1 subtypes. Results The median monthly rate of CD4+ T cell decline was -2.20 [interquartile range (IQR): -11.36-2.13] cell/μl. Of all patients, 25.5% (24/94) had a significant decline (≥30%) in CD4+ T cell count. Compared with the patients infected with CRF01_AE, those infected with CRF07_BC (OR=0.28, 95%CI: 1.7-6.5) or other subtypes (OR=0.16, 95%CI: 1.0-2.9) had a lower risk of significant decline in CD4+ T cell count. In addition, results of the nonparametric test showed that the patients infected with CRF01_AE (M=-21.54, IQR: -30.97--11.92 cell/μl) had a faster CD4+ T cell loss than those infected with CRF07_BC (M=-11.26, IQR: -14.06--5.63 cell/μl) (P=0.033). Conclusion HIV-1 subtype is associated with the rate of CD4+ T cell decline. It is important to monitor the changes in CD4+ T cell count in patients infected with CRF01_AE and to carry out timely ART. Key words: HIV-1; Subtype; CD4+ T lymphocyte; Correlation analysis