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Race and CD4+ T-cell count in HIV prognosis and treatment

    &
    Janaki Amin

    The Kirby Institute for Infection & Immunity in Society (formerly National Centre in HIV Epidemiology & Clinical Research), University of New South Wales, 2052, Sydney, New South Wales, Australia

    Published Online:https://doi.org/10.2217/fvl.11.143

    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.

    Papers of special note have been highlighted as: ▪ of interest ▪▪ of considerable interest

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