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  • Heterozygosity for a defect...
    Cohen, O J; Vaccarezza, M; Lam, G K; Baird, B F; Wildt, K; Murphy, P M; Zimmerman, P A; Nutman, T B; Fox, C H; Hoover, S; Adelsberger, J; Baseler, M; Arthos, J; Davey, Jr, R T; Dewar, R L; Metcalf, J; Schwartzentruber, D J; Orenstein, J M; Buchbinder, S; Saah, A J; Detels, R; Phair, J; Rinaldo, C; Margolick, J B; Pantaleo, G; Fauci, A S

    The Journal of clinical investigation, 1997-Sep-15, 1997-9-15, 19970915, Volume: 100, Issue: 6
    Journal Article

    HIV-1-infected long-term nonprogressors are a heterogeneous group of individuals with regard to immunologic and virologic markers of HIV-1 disease. CC chemokine receptor 5 (CCR5) has recently been identified as an important coreceptor for HIV-1 entry into CD4+ T cells. A mutant allele of CCR5 confers a high degree of resistance to HIV-1 infection in homozygous individuals and partial protection against HIV disease progression in heterozygotes. The frequency of CCR5 heterozygotes is increased among HIV-1- infected long-term nonprogressors compared with progressors; however, the host defense mechanisms responsible for nonprogression in CCR5 heterozygotes are unknown. We hypothesized that nonprogressors who were heterozygous for the mutant CCR5 gene might define a subgroup of nonprogressors with higher CD4+ T cell counts and lower viral load compared with CCR5 wild-type nonprogressors. However, in a cohort of 33 HIV-1-infected long-term nonprogressors, those who were heterozygous for the mutant CCR5 gene were indistinguishable from CCR5 wild-type nonprogressors with regard to all measured immunologic and virologic parameters. Although epidemiologic data support a role for the mutant CCR5 allele in the determination of the state of long-term nonprogression in some HIV-1- infected individuals, it is not the only determinant. Furthermore, long-term nonprogressors with the wild-type CCR5 genotype are indistinguishable from heterozygotes from an immunologic and virologic standpoint.