CCR5 genotype and pre-treatment CD4+T-cell count influence immunological recovery of HIV-positive patients during antiretroviral therapy

摘要

This study was performed to assess the association of CCR5 Delta 32 and SDF1-3'A polymorphisms with immunological recovery failure and to investigate the influence of sociodemographic and clinical data on immune reconstitution in human immunodeficiency virus (HIV)-positive patients during antiretroviral therapy (ART). Two hundred and forty-eight HIV-positive patients under ART with undetectable plasma viral load ( = 200/mu L or >= 30% compared with baseline) and immunological non-responders (CD4+ T-cell count gain < 200/mu L or < 30% compared with baseline). DNA extraction was performed followed by CCR5.32 and SDF1-3'A genotyping. Sociodemographic and clinical data were evaluated from medical records. The logistic regression model showed that heterozygosity for CCR5 Delta 32 allele and lower pre-treatment CD4+ T-cell count (< 500 cells/mu L) were statistically associated with immunological recovery failure (OR = 5.873, 95%CI = 1.204-28.633, P = 0.028 and OR = 10.00, 95%CI = 3.224-31.016, P = 0.028, respectively). No association of SDF1-3'A polymorphism with immune reconstitution failure was found. Additionally, we observed that there was a statistically significant difference between lower CD4+ T-cell count and INR status than the IR group (Z = 4.687, P < 0.001). Our results demonstrated, through a logistic regression model, that CCR5.32 polymorphism and pre-treatment CD4+ T-cell count have significant influence on immune reconstitution of HIV-positive patients during ART. These findings highlight some immunological factors associated with poor CD4+ T-lymphocytes recovery, which affect immune response level of ART-treated HIV-positive patients.