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Re: CCR5 and CXCR4
Apr 15, 2005

Dr. Whol, At what CD4 counts do people go from CCR5 to CXCR4?

If you have crossed that line, are there therapies that combine the two to look forward to?

Furthermore, if that number is great than 350, it's a shame people are instructed to wait until then to go an therapy.

What are your thoughts?

Response from Dr. Wohl

There is no cut off CD4 cell count at which this occurs. I have a patient with a CD4 cell count of 90 who just entered a study of a CCR5 blocker and had only CCR5 tropic virus. There is a tendency for there to be more CXCR4 tropic virus the lower the CD4 cell count.

Whether the advent of CCR5 blockers will influence when we start therapy, we will see. There are really good reasons that therapy is delayed. Plus, as mentioned at counts of 350 or so CCR5 tropic virus is common.

DW



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