1. Control of the HIV-1 Load Varies by Viral Subtype in a Large Cohort of African Adults With Incident HIV-1 Infection
- Author
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Eric Hunter, Ggayi Abu-Baker, Kristin M. Wall, Freddie Kibengo, Jianming Tang, Paramesh Chetty, Pholo Maenetje, Shabir Lakhi, Omu Anzala, William Kilembe, Eduard J. Sanders, Jill Gilmour, Mubiana Inambao, Patricia E. Fast, Etienne Karita, Fran Priddy, Susan Allen, Wasima Rida, Matthew Price, Eugene Ruzagira, Heeran Makkan, Vinodh A. Edward, Linda-Gail Bekker, Pontiano Kaleebu, Gaudensia Mutua, Anatoli Kamali, Amanda Tichacek, and Mary H. Latka
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Major Articles and Brief Reports ,03 medical and health sciences ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Internal medicine ,Epidemiology ,medicine ,Immunology and Allergy ,030212 general & internal medicine ,Prospective cohort study ,HIV-1 Load ,business.industry ,HIV ,Odds ratio ,medicine.disease ,HIV subtype ,Confidence interval ,3. Good health ,AIDS ,030104 developmental biology ,Infectious Diseases ,Africa ,Cohort ,HIV/AIDS ,epidemiology ,Corrigendum ,business ,Viral load - 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., Human immunodeficiency virus type 1 (HIV-1) subtype is important. We show that HIV subtype A is associated with viral control, using subtype C as a reference. Data from this and other studies suggest that HIV-1 subtype should be considered when designing new HIV therapeutic agents, prevention modalities, and vaccines.
- Published
- 2019