Low CD4 T Cell Counts before HIV‐1 Seroconversion Do Not Affect Disease Progression in Ethiopian Factory Workers

Abstract

Background. Human immunodeficiency virus type 1 (HIV-1)-uninfected Ethiopians have lower CD4 T cell counts than do other populations in Africa and industrialized countries. We studied whether this unique immunological profile results in shorter survival times in HIV-1-infected Ethiopians.Methods.Data from an open cohort study of 149 HIV-1-infected factory workers in Ethiopia for 1997-2002 were used. To estimate survival times, a continuous-time Markov model was designed on the basis of CD4 T cell counts and World Health Organization clinical staging. By use of a random-effects model, decline in CD4 T cell counts was compared between HIV-1-infected Ethiopian and Dutch individuals.Results. Median survival times were in the range of 9.1-13.7 years, depending on the approach used. This range is similar to that for populations in industrialized countries before the advent of antiretroviral therapy. Ethiopians had a lower annual decline in CD4 T cell counts than did Dutch individuals, which remained when groups with similar CD4 T cell count categories were compared. Moreover, the slower decline in CD4 T cell counts was not due merely to lower HIV-1 RNA loads or an absence of syncytium-inducing/X4 HIV-1 subtype C strains in Ethiopians.Conclusions. Low baseline CD4 T cell counts do not imply shorter survival times in Ethiopians than in other populations, presumably because of a slower decline in CD4 T cell counts.

HIV Infection, Antiretroviral Therapy, and CD4+Cell Count Distributions in African Populations

“…The key assumption is that life expectancy is independent of the initial CD4 + cell count, and this was supported by the model predictions for South Africa and Zambia (figure 3). Furthermore, a study in Ethiopia found that, although CD4 + cell counts in HIV-positive people were lower than those elsewhere (figure 1), the life expectancy was similar to that in The Netherlands [43], which suggests that the rate of CD4 + cell count decrease in Ethiopia is proportionately slow and confirms the prediction of our model.…”

Impact of Hepatitis C Virus on the Circulating Levels of IL-7 in HIV-1 Coinfected Women

“…Some studies suggest that HAART can prevent age-related changes in CD4 + T-cell composition and normalize the rate of CD4 + count gain between people of diverse races [37, 40, 41]. Although several studies suggest the opposite [42–44], this HAART effect may explain, at least in part, the loss of associations of IL-7 levels with race and age in HAART-treated women.…”

Comparison of Early CD4 T-Cell Count in HIV-1 Seroconverters in Côte d'Ivoire and France: The ANRS PRIMO-CI and SEROCO Cohorts

“…14 In a study comparing Ethiopian and Dutch individuals, CD4 + decrease was lower in Ethiopians for a same CD4 + level. 15 …”

“…Few studies have compared the decline of CD4 cell count between highincome and low-income settings, and their results are discrepant. [12][13][14][15] In this study, we aimed at exploring whether the decline in CD4 + cells differed after controlling for a set of key factors: age, gender, HIV-1 RNA, and HIV-1 DNA. We compared the decline in CD4 + before antiretroviral treatment and associated factors in 2 cohorts of HIV-1-infected adults with an estimated date of seroconversion in Côte d'Ivoire and in France.…”