Correlating HIV tropism with immunological response under cART. HIV Medicine
Bader et al. assessed whether a HIV tropism determination prior to combination antiretroviral therapy (cART) initiation would be able to predict a later poorer immune response. Of the 88 baseline profiles available for comparison of immunological responses, 82.1% carried an R5-tropic virus and 17.9% an X4-tropic virus. Sixty percent of all patients with X4-tropic viruses at therapy initiation experienced only partial immune recovery during the following 5 years (ΔCD4 <400 cells/µL). In a majority of patients, the tropism determination “changed” from X4-tropic at baseline to R5. In contrast, most patients with R5 tropism at baseline retained R5-tropic viruses. The study-results lend support to the hypothesis that tropism determination can be used as a parameter for disease progression even if analysed long before the establishment of a poorer immune response.