TheCCR5Δ32Allele Slows Disease Progression of Human Immunodeficiency Virus–1–Infected Children Receiving Antiretroviral Treatment

Abstract

The role of the CCR5Δ32 allele in human immunodeficiency virus (HIV)-1-related disease progression was analyzed for 457 antiretroviral-naïve children who had participated in the Pediatric AIDS Clinical Trials Group 152 study, which demonstrated that didanosine (ddI) or zidovudine + ddI treatments were superior to zidovudine alone. The CCR5Δ32 allele was detected at an overall frequency of 6.1% (28/457). At study entry, heterozygote children (wild type [wt]/Δ32) had higher baseline median CD4⁺ counts/mm³ than wt/wt children had (1035 vs. 835 cells/mm³ P = .043), higher mean weight-for-age Z scores (−0.15 vs. −0.84; P = .01), and a trend toward less cortical atrophy (P = .059). During antiretroviral treatment and study follow-up, there was a trend toward less disease progression and death among heterozygote children than among wt/wt children (P = .056; relative hazard, 0.28; 95% confidence interval, 0.07–1.13) independent of the antiretroviral treatment to which they were randomized.