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Drug-Resistant HIV Causes Bigger CD4 Drop in First Year

However, no evidence of long-term effect on natural history of HIV-1 infection

TUESDAY, Dec. 27 (HealthDay News) -- Patients who are infected with a drug-resistant HIV strain have a more rapid decline in CD4 cell count, although the greatest decline is seen in the first year, according to a study in the Jan. 2 issue of AIDS. There is no evidence of impact on the natural history of HIV-1 infection over the longer term, the authors say.

Members of the CASCADE Virology Collaboration analyzed data from 300 HIV-1 infected, antiretroviral-naive individuals who were recruited between 1987 and 1993. Resistance tests were conducted within 18 months of infection. The authors estimated the impact of transmitted drug resistance (TDR) on CD4 cell count decline in patients who did not receive any subsequent treatment.

Over the first year of infection, a steeper decline of CD4 cell count was associated with infection with any form of drug-resistant HIV-1. The estimated rates of decline were 5.0 √CD4 cells per year for TDR and 1.7 √CD4 cells per year for no TDR. In a patient with a CD4 cell count of 500 cells/μl at seroconversion, these rates correspond to a CD4 cell loss of 199 and 73 cells/μl, respectively, in the first year after infection.

"TDR is associated with a rapid CD4 cell decline soon after infection, suggesting that these viruses represent a specific group of variants. However, we find no evidence that these viruses confer either a long term advantage or disadvantage in the absence of therapy," the authors conclude.

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