Racial differences in rate of CD4 decline in HIV-1 infected homosexual men.

Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.

Racial differences in rate of CD4 decline in HIV-1 infected homosexual men.

Int Conf AIDS. 1992 Jul 19-24;8(1):Mo17 (abstract no. MoC 0064). Unique Identifier : AIDSLINE ICA8/92400020
Easterbrook PJ; Margolick J; Saah AJ; Farzadegan H; Kaslow R; Vlahov D; Chmiel J; Johns Hopkins School of Public Health, Baltimore, MD.

Abstract: OBJECTIVE: To determine if racial differences exist in the rate of CD4 cell decline, progression to AIDS and survival in HIV-1 infected homosexual men. METHODS: Prospective cohort study of 321 non-Hispanic white (W) and 102 black (B) HIV-1 seropositive homosexual men recruited from the Baltimore/Washington D.C. metropolitan areas between 1984-1985 and 1987-1990, and evaluated semi-annually. Change in CD4 count over time was analyzed using linear regression procedures for the 271 W and 69 B participants who had at least 4 semi-annual CD4 counts. RESULTS: Decline in CD4 cell count over time was much slower among B compared to W seroprevalent men for all categories of baseline CD4 count. TABULAR DATA, SEE ABSTRACT VOLUME. These racial differences persisted after adjustment for age at baseline, recruitment period (1984-1985, 1987-1990), duration of follow-up, and receipt of zidovudine therapy or PCP prophylaxis. Similar findings were also observed among the 32 W and 11 B seroconverters but not with the W and B seronegative controls. No significant racial differences were found in the rate of progression to AIDS or in overall survival, but the number of these events among non-whites was small (15 AIDS cases and 11 deaths). CONCLUSIONS: This preliminary analysis suggests a more gradual CD4 cell decline among black Americans. The clinical significance of and reasons for this are unclear, but racial differences in the immune response to HIV may exist. Additional longitudinal studies are in progress to validate these findings in a larger cohort of non-whites, and to assess their relationship with other measures of cell-mediated immune function and levels of p24 antigenemia.

Keywords: Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY Baltimore/EPIDEMIOLOGY *Caucasoid Race Cohort Studies Comparative Study *CD4-Positive T-Lymphocytes District of Columbia/EPIDEMIOLOGY Homosexuality Human HIV Infections/BLOOD/*EPIDEMIOLOGY/IMMUNOLOGY *HIV-1 Leukocyte Count Male *Negroid Race Prospective Studies Survival Rate Urban Population ABSTRACT
921230
M92C5327

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