Price, Matt A; Rida, Wasima; Kilembe, William; Karita, Etienne; Inambao, Mubiana; Ruzagira, Eugene; Kamali, Anatoli; Sanders, Eduard J; Anzala, Omu; Hunter, Eric; +18 more... Allen, Susan; Edward, Vinodh A; Wall, Kristin M; Tang, Jianming; Fast, Patricia E; Kaleebu, Pontiano; Lakhi, Shabir; Mutua, Gaudensia; Bekker, Linda Gail; Abu-Baker, Ggayi; Tichacek, Amanda; Chetty, Paramesh; Latka, Mary H; Maenetje, Pholo; Makkan, Heeran; Kibengo, Freddie; Priddy, Fran; Gilmour, Jill; (2019) Control of the HIV-1 Load Varies by Viral Subtype in a Large Cohort of African Adults With Incident HIV-1 Infection. The Journal of infectious diseases, 220 (3). pp. 432-441. ISSN 0022-1899 DOI: https://doi.org/10.1093/infdis/jiz127
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Abstract
Few human immunodeficiency virus (HIV)-infected persons can maintain low viral levels without therapeutic intervention. We evaluate predictors of spontaneous control of the viral load (hereafter, "viral control") in a prospective cohort of African adults shortly after HIV infection. Viral control was defined as ≥2 consecutively measured viral loads (VLs) of ≤10 000 copies/mL after the estimated date of infection, followed by at least 4 subsequent measurements for which the VL in at least 75% was ≤10 000 copies/mL in the absence of ART. Multivariable logistic regression characterized predictors of viral control. Of 590 eligible volunteers, 107 (18.1%) experienced viral control, of whom 25 (4.2%) maintained a VL of 51-2000 copies/mL, and 5 (0.8%) sustained a VL of ≤50 copies/mL. The median ART-free follow-up time was 3.3 years (range, 0.3-9.7 years). Factors independently associated with control were HIV-1 subtype A (reference, subtype C; adjusted odds ratio [aOR], 2.1 [95% confidence interval {CI}, 1.3-3.5]), female sex (reference, male sex; aOR, 1.8 [95% CI, 1.1-2.8]), and having HLA class I variant allele B*57 (reference, not having this allele; aOR, 1.9 [95% CI, 1.0-3.6]) in a multivariable model that also controlled for age at the time of infection and baseline CD4+ T-cell count. We observed strong associations between infecting HIV-1 subtype, HLA type, and sex on viral control in this cohort. HIV-1 subtype is important to consider when testing and designing new therapeutic and prevention technologies, including vaccines.
Item Type | Article |
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Faculty and Department |
MRC Uganda > UG-HIV Prevention & Epidemiology MRC Uganda > UG-HIV Care |
PubMed ID | 30938435 |
Elements ID | 135835 |
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Filename: HIV-1 viral control varies by viral subtype in a large cohort of African adults with incident HIV-1 infection.pdf
Licence: Creative Commons: Attribution 3.0
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