Control of the HIV-1 Load Varies by Viral Subtype in a Large Cohort of African Adults With Incident HIV-1 Infection
Year: 2019
Type: article
Study design: Observational Study
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.
Authors: Matt A Price, Wasima Rida, William Kilembe, Etienne Karita, Mubiana Inambao, Eugene Ruzagira, Anatoli Kamali, Eduard J Sanders, Omu Anzala, Eric Hunter, Susan Allen, Vinodh A Edward, Kristin M Wall, Jianming Tang, Patricia E Fast, Pontiano Kaleebu, Shabir Lakhi, Gaudensia Mutua, Linda Gail Bekker, Ggayi Abu-Baker, Amanda Tichacek, Paramesh Chetty, Mary H Latka, Pholo Maenetje, Heeran Makkan, Freddie Kibengo, Fran Priddy, Jill Gilmour
Institutions: International AIDS Vaccine Initiative, University of California, San Francisco, Rwanda Zambia HIV Research Group, MRC/UVRI & LSHTM Uganda Research Unit, Uganda Virus Research Institute, Kenya Medical Research Institute, University of Oxford, Kenya AIDS Vaccine Initiative, Emory University, South African Medical Research Council, Desmond Tutu HIV Foundation, Yale University, University of the Witwatersrand
Language: English
Topic: HIV Research and Treatment
Subfield: Virology
Field: Immunology and Microbiology
Domain: Life Sciences
Open Access status: hybrid
Estimated APC paid: $4,763
Funders: United States Agency for International Development, Bill and Melinda Gates Foundation, International AIDS Vaccine Initiative, World Bank Group, Emory University, Irish Aid, Imperial College London, Department for International Development, Udenrigsministeriet, National Institutes of Health, Center for AIDS Research, University of Washington, Medical Research Council, National Institute of Allergy and Infectious Diseases, Fogarty International Center
OpenAlex ID: W2932596990