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Human immunodeficiency virus (HIV) uses 2 distinct chemokine receptors, CCR5 (R5) or CXCR4 (X4), during entry. Viruses may be R5 tropic, X4 tropic, or dual/mixed (D/M) tropic. R5-tropic virus predominates at high CD4 cell counts, with the number of X4-tropic strains increasing as CD4 cell count decreases.

The Impact of HIV Tropism on Decreases in CD4 Cell Count, Clinical Progression, and Subsequent Response to a First Antiretroviral Therapy Regimen