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Genetic Variation Associated With Survival Advantage in African Americans With HIV
Date:7/20/2009

nical data from 1,132 participants. The researchers tested for the presence of the DARC variation and evaluated patients' WBC counts from diagnosis and throughout the course of the disease to determine the impact of different levels of WBC counts on survival rates. The prevalence of leukopenia at the time of diagnosis was significantly higher in African Americans (28 percent) than in European Americans (15 percent) or other ethnicities (13 percent). The average WBC counts were also significantly lower during the course of the disease in African Americans with HIV than in other ethnicities.

The researchers found that leukopenia was generally associated with a faster disease progression from HIV to AIDS, independent of known predictors of AIDS development. "On average, leukopenic European Americans progressed nearly three times faster than their non-leukopenic African or European counterparts," explained Hemant Kulkarni, MD, first author of this study. "However, leukopenic African Americans had a slower disease course than leukopenic European Americans, even though twice as many African Americans in the study had leukopenia."

The investigators found that the DARC variation, not race, explained the differences in WBC counts in African Americans with HIV. Among those who were leukopenic, only those with the DARC variation experienced a significant survival benefit. Additionally, this survival advantage became increasingly pronounced in those with progressively lower WBC counts, suggesting that the interaction between DARC and WBC counts was the primary influence on slowing HIV disease progression in African Americans.

"The results of this collaborative study highlight the importance of accounting for other factors, such as the white blood cell count, to uncover the full effects of genetic variations that may influence HIV disease course," said Capt. Gregory Martin, MD, United States Navy, program director
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SOURCE American Society of Hematology
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