Race and CD4+ T-cell count in HIV prognosis and treatment. (February 2012)

• Record Type: Journal Article
• Authors: Achhra, Amit C; Amin, Janaki
• Is Part Of: Future virology. Volume 7:Number 2(2012)
• Page Start: 193
• Page End: 203
• Publication Date: 2012-02
• Subjects: African–American -- antiretroviral -- Asian -- black -- Caucasian -- CD4+ count -- ethnicity -- HIV -- race -- white; Virology -- Periodicals; Virus diseases -- Treatment -- Periodicals; 616.9101
• DOI: 10.2217/fvl.11.143
• Languages: English
• ISSNs: 1746-0794

Abstract

CD4 + T-cell count is known to vary by race in HIV-negative individuals. While people of certain races, such as blacks and Asians, continue to be disproportionately burdened by HIV/AIDS, they remain under-represented in most HIV clinical studies. Recent studies suggest that CD4 + count evolution in HIV, before and after therapy, may differ by race. In this review, we summarize the evidence from prospective cohorts comparing CD4 + count trajectories by race, and whether it is of any clinical significance. We find that although minor differences in CD4 + count trajectories exist between people of diverse races, socioeconomic, cultural and environmental differences are far more important in predicting clinical outcomes than racial differences in CD4 + count. Furthermore, current evidence does not support the need for any race or ethnicity-specific CD4 + thresholds for ART and prophylactic therapy initiation. Future long-term trials in racially diverse populations are required to substantiate these findings.