Risk of All-Cause Mortality in HIV Infected Patients Is Associated with Clinical, Immunologic Predictors and the CCR5 Δ32 Deletion
2011

Impact of CCR5 Δ32 Deletion on Mortality in HIV Patients

Sample size: 507 publication 10 minutes Evidence: moderate

Author Information

Author(s): Parczewski Milosz, Bander Dorota, Leszczyszyn-Pynka Magdalena, Urbanska Anna, Kaczmarczyk Mariusz, Ciechanowicz Andrzej, Boron-Kaczmarska Anna

Primary Institution: Pomeranian Medical University, Szczecin, Poland

Hypothesis

The study investigates the interplay between the CCR5 Δ32 genotype and various factors associated with mortality in HIV-infected patients.

Conclusion

The CCR5 Δ32 allele is associated with a reduction in the risk of all-cause mortality in HIV-positive patients, influenced by clinical and immunologic factors.

Supporting Evidence

  • The CCR5 Δ32 genotype frequency was 14.0% among the studied patients.
  • Univariate analysis showed that the CCR5 genotype significantly modified the risk of death.
  • Patients with a stable CD4 count above 500 cells/µl had a significantly lower mortality risk.
  • History of AIDS was associated with a higher risk of mortality.
  • Antiretroviral treatment history significantly influenced survival outcomes.
  • Among untreated individuals, the Δ32/wt genotype was associated with better survival.
  • Statistical significance was observed for various clinical and immunologic predictors of mortality.
  • The study highlights the importance of early treatment initiation in improving survival rates.

Takeaway

People with a specific genetic change (CCR5 Δ32) may live longer with HIV, especially if they have good immune health and receive treatment early.

Methodology

Longitudinal data from 507 HIV-infected patients were analyzed using Kaplan-Meyer methodology and Cox regression models.

Potential Biases

Potential bias due to interval censoring for some cases and late diagnosis of HIV in the population studied.

Limitations

The study could not observe patients from the time of seroconversion and lacked information on treatment adherence.

Participant Demographics

All participants were Caucasian, predominantly male (79.5%), with a median age of 30 years.

Statistical Information

P-Value

p=0.02 for CCR5 genotype

Confidence Interval

CI 2.57–3.19 for mortality rate

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1371/journal.pone.0022215

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