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Evaluation of HIV-1 DNA levels among adolescents living with perinatally acquired HIV-1 in Yaounde, Cameroon: A contribution to paediatric HIV cure research in Sub-Saharan Africa.
- Source :
-
Journal of virus eradication [J Virus Erad] 2024 Mar 30; Vol. 10 (1), pp. 100367. Date of Electronic Publication: 2024 Mar 30 (Print Publication: 2024). - Publication Year :
- 2024
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Abstract
- Background: With the advent of antiretroviral therapy (ART), most children living with HIV in sub-Saharan Africa (SSA) are growing toward adolescence, with scarcity of evidence on the size of viral reservoirs to enhance paediatric cure research strategies. This study aims to compare HIV-1 proviral DNA levels according to virological response among adolescents living with perinatally acquired HIV-1 (ALPHIV) and identify associated-factors in the Cameroonian context.<br />Methods: In this observational cohort study, HIV-1 RNA viremia and CD4 <superscript>+</superscript> T-cell count were assessed through RT-PCR and flow cytometry respectively at three time-points over 18 months of observation. At the third time-point, 80 randomly-selected participants were classified as with viremia (≥50 HIV-1 copies/mL; n = 40) or without viremia (<50 HIV-1 copies/mL; n = 40); immune-competent (≥500 CD4 <superscript>+</superscript> T cells/mm <superscript>3</superscript> ) or immunocompromised (<500 CD4 <superscript>+</superscript> T cells/mm <superscript>3</superscript> ). Among these participants, total HIV-1 DNA load was quantified through droplet digital PCR using Bio-Rad QX200.<br />Results: Of the 80 randomly-selected adolescents, median [IQR] age was 15 (13-17) years, 56.2% were female, duration on ART was 9.3 [5.4-12.2] years. Among the 40 viremic ones (median viremia 7312 [283-71482]) HIV-1 copies/ml, 75.0% (30/40) were in virological failure (≥1000 HIV-1 copies/ml), while median of CD4 T cells were 494 [360-793] cell/mm <superscript>3</superscript> with 48.8% (39/80) immunocompromised. No significant variation in HIV-1 RNA viremia and CD4 T cell count was observed between the three time-points, and 13.7% (11/80) adolescents remained aviremic and immune-competent throughout (stable adolescents). A positive and moderate correlation (r = 0.59; p < 0.001) was found between HIV-1 DNA levels and HIV- 1 RNA viremia. Regarding the CD4 T cell count, a negative and weak correlation (r = -0.28; p = 0.014) was found with HIV-1 DNA loads only among adolescents with viremia. Starting ART within the first year of life, ART for over 9 years and aviremia appear as predictors of low HIV-1 DNA loads.<br />Conclusion: Among ALPHIV, high HIV-1 RNA indicates an elevated viral reservoir size, representing a drawback to cure research. Interestingly, early ART initiation and longer ARTduration lead to sustained viral control and limited HIV-1 reservoir size. As limited size of viral reservoir appears consistent with viral control and immune competence, adolescents with sustained viral control (about 14% of this target population) would be candidates for analytical ART interruptions toward establishing paediatric post-treatment controllers in SSA.<br />Competing Interests: The authors declared there are no conflicts of interest.<br /> (© 2024 The Authors.)
Details
- Language :
- English
- ISSN :
- 2055-6640
- Volume :
- 10
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of virus eradication
- Publication Type :
- Academic Journal
- Accession number :
- 38601701
- Full Text :
- https://doi.org/10.1016/j.jve.2024.100367