We compared CD4+ decline among untreated HIV-1-infected seroconverters living in Côte d'Ivoire (CI) and in France.
HIV-1-infected adults were enrolled in the ANRS1220 PRIMO-CI (CI, 1997-2006) and ANRSCO2 SEROCO (France, 1988-1995) cohorts. CD4+ count and percentage declines were estimated from enrollment until 24 months of seroconversion by linear random-effect models adjusted for time since seroconversion, age, gender, cell-associated HIV DNA, HIV RNA, and country.
Overall 521 seroconverters (CI 148, 62% men; France 373, 77% men) were enrolled after a median of 7.6 months since seroconversion. Median follow-up duration was 12.7 months. Median age was 28 years. Median baseline CD4+ count was 472 and 560 cells per cubic millimeter, respectively. Median baseline HIV RNA was 4.4 and 4.0 log10 copies per milliliter and median HIV DNA was 3.0 and 2.8 log10 copies per 106 peripheral blood mononuclear cells, respectively. In adjusted models, CD4+ count and percentage at baseline were lower in CI than in France (P < 0.01), and the difference did not vary during follow-up (P = 0.55). Low HIV RNA and low HIV DNA at baseline were associated with higher CD4+ count at baseline.
CD4+ count and percentage were lower in CI than in France. These differences were already observed during early infection and remained similar after adjustment.
From the *Inserm, U897, Bordeaux, France; †Université Victor Segalen Bordeaux 2, Institut de Santé Publique, d'Epidémiologie et de Développement, Bordeaux, France; ‡Inserm, U822, Université Paris Sud 11, Assistance Publique Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France; §Programme PACCI, Abidjan, Côte d'Ivoire; and ‖Hôpital Necker, Laboratoire de virologie, Paris, France.
Received for publication March 12, 2009; accepted July 13, 2009.
Supported by Agence Nationale de Recherches sur le Sida et les Hépatites Virales.
These results were presented partly at the 15th Conference on Retroviruses and Opportunistic Infections, February 3-6, 2008, Boston, MA.
Correspondence to: Charlotte Lewden, MD, PhD, Inserm U897, ISPED, Université de Bordeaux 2, 146 rue Léo-Saignat 33076 Bordeaux cedex, France (e-mail: email@example.com).