Bander, D

Boron-Kaczmarska, A

Ciechanowicz, S

Kaczmarczyk, M

Leszczyszyn-Pynka, M

Parczewski, M

Urbañska, A

English

PubMed

M Parczewski

M Leszczyszyn-Pynka

D Bander

A Urbañska

M Kaczmarczyk

S Ciechanowicz

A Boron-Kaczmarska

Springer - Publisher Connector

CCR5 D32 modifies 15-year mortality risk associated with well-established clinical and immunological factors among HIV-infected patients

POSTER PRESENTATION Open Access
CCR5 D32 modifies 15-year mortality risk
associated with well-established clinical and
immunological factors among HIV-infected
patients
M Parczewski1*, M Leszczyszyn-Pynka1, D Bander1, A Urbañska1, M Kaczmarczyk2, S Ciechanowicz2,
A Boron-Kaczmarska1
From Tenth International Congress on Drug Therapy in HIV Infection
Glasgow, UK. 7-11 November 2010
Purpose of the study
In the era of long term follow up of HIV+ patients ana-
lysis of factors modifying risk of death is vital. The aim
of the study was to evaluate predictive value of selected
parameters in a cross-sectional analysis.
Methods
Epidemiological (age, gender, date of HIV diagnosis,
route of transmission), clinical (date and reason of
AIDS, date and reason of death, baseline viral load,
history of cART) and immunological (baseline, nadir,
zenith lymphocyte CD4 counts, time of CD4 count >
500 cells/ml) data from 506 patients followed-up from
1996 to 2010 in the Department of Infectious Diseases
and Hepatology, Szczecin, Poland were collected with
CCR5 D32 genotyping performed for every subject. 15-
year survival analysis was performed using Kaplan-
Meier methodology with log rank test and univariate
Cox regression for hazard ratio calculation. Selected
data were implemented into a Cox multivariate model
and p< 0.05 assumed of statistical significance.
Results
Cumulative 15-year mortality rate was 18,5% (95% CI
0,15-0,21), with 64 (68,8%) of AIDS associated and 30
(32,2%) non-AIDS deaths. At 15 year timepoint factors
associated with higher probability of survival were CCR5
D32/wt genotype (78,3% vs 65,3%, p =0 ,033, univariate
[univ.] HR=2,21, p=0,044), female gender (81,7% vs
62,5%, p=0,014; univ. HR=1,98, p=0,015), AIDS-free at
HIV diagnosis (70,6%vs 59,3%, p <0,01; univ. HR=2,8,
p<0,01) and no AIDS during observation (79,4% vs
50,8%, p<0,01, univ. HR=3,58, p<0,01), introduction of
cART (74,4% vs 34,2%, p <0,01; univ. HR=3,68, p<0,01),
baseline lymphocyte CD4 count >50 cells/ml (71,3% vs
56,5%, p <0,01, univ. HR=2,52, p<0,01), lymphocyte
CD4 nadir >50 cells/ml (75,8% vs 55,9%, p =0 ,00007,
univ. HR=2,31, p<0,01), CD4 zenith >500 cells/ml (85,1
% vs 52,8%, p <0,01, , univ. HR=5,22, p<0,01), stable
lymphocyte CD4 count > 500 cells/ml for one year
(88,2% vs 60,4%, p<0,01, univ. HR=7,59, p<0,01). In
multivariate model with gender (HR=1,86 , p=0,04),
cART initiation (HR=4,62 p<0,01), lymphocyte CD4
zenith >500 (HR=3,86, p<0,01), nadir > 50 (p=n.s) and
history of AIDS (HR=2,2 p=0,03) positive effect of
CCR5 D32/wt on survival was confirmed (HR=2,2,
p=0,046).
Conclusions
CCR5 D32 mutation proves to improve survival of HIV+
patients acting in concert with clinical and immunologi-
cal factors, however data suggest that interventions
related to early testing and treatment would strongly
influence survival in HIV+ patients.
1Department of Infectious Diseases and Hepatology, Pomeranian Medical
University, Arkoñska 4, Szczecin, Poland
Full list of author information is available at the end of the article
Parczewski et al. Journal of the International AIDS Society 2010, 13(Suppl 4):P151
http://www.jiasociety.org/content/13/S4/P151
© 2010 Parczewski et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative
Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and
reproduction in any medium, provided the original work is properly cited.
Author details
1Department of Infectious Diseases and Hepatology, Pomeranian Medical
University, Arkoñska 4, Szczecin, Poland. 2Pomeranian Medical University,
Department of Molecular Medicine, Szczecin, Poland.
Published: 8 November 2010
doi:10.1186/1758-2652-13-S4-P151
Cite this article as: Parczewski et al.: CCR5 D32 modifies 15-year
mortality risk associated with well-established clinical and
immunological factors among HIV-infected patients. Journal of the
International AIDS Society 2010 13(Suppl 4):P151.
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Parczewski et al. Journal of the International AIDS Society 2010, 13(Suppl 4):P151
http://www.jiasociety.org/content/13/S4/P151
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CCR5 D32 modifies 15-year mortality risk associated with well-established clinical and immunological factors among HIV-infected patients

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