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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Extended high viremics: A substantial fraction of individuals maintain high plasma viral RNA levels after acute HIV-1 subtype C infection
AIDS, Volume 25, No. 12, Year 2011
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Description
Objective: The present study addressed two questions: what fraction of individuals maintain a sustained high HIV-1 RNA load after the acute HIV-1C infection peak and how long is a high HIV-1 RNA load maintained after acute HIV-1C infection in this subpopulation? DESIGN/Methods: Plasma HIV-1 RNA dynamics were studied in 77 participants with primary HIV-1C infection from African cohorts in Gaborone, Botswana, and Durban, South Africa. HIV-infected individuals who maintained mean viral load of at least 100000 (5.0 log10)copies/ml after 100 days postseroconversion (p/s) were termed extended high viremics. Individuals were followed longitudinally for a median [interquartile range (IQR)] of 573 (226-986) days p/s. Results: The proportion of extended high viremics was 34% [95% confidence interval (CI) 23-44%] during the period 100-300 days p/s and 19% (95% CI 9-29%) over the period of 200-400 days p/s. The median (IQR) duration of HIV-1 RNA load at least 100000copies/ml among extended high viremics was 271 (188-340) days p/s. For the subset with average viral load at least 100000copies/ml during 200-400 days p/s, the median (IQR) duration was 318 (282-459) days. The extended high viremics had a significantly shorter time to CD4+ cell decline to 350cells/μl (median: 88 vs. 691 days p/s for those not designated as extended high viremics; P<0.0001, Gehan-Wilcoxon test). Conclusion: A high proportion of extended high viremics-individuals maintaining high plasma HIV-1 RNA load after acute infection-have been identified during primary HIV-1 subtype C infection. These extended high viremics likely contribute disproportionately to HIV-1 incidence. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Authors & Co-Authors
Novitsky, Vladimir A.
United States, Boston
Harvard T.h. Chan School of Public Health Aids Initiative
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
Ndung'u, Thumbi P.
South Africa, Durban
University of Kwazulu-natal
United States, Cambridge
Massachusetts Institute of Technology
Wang, Rui
United States, Boston
Harvard T.h. Chan School of Public Health Aids Initiative
Bussmann, Hermann
United States, Boston
Harvard T.h. Chan School of Public Health Aids Initiative
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
Chonco, Fundisiwe M.
South Africa, Durban
University of Kwazulu-natal
Makhema, Joseph M.
United States, Boston
Harvard T.h. Chan School of Public Health Aids Initiative
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
Gruttola, Victor De
United States, Boston
Harvard T.h. Chan School of Public Health Aids Initiative
Walker, Bruce D.
United States, Cambridge
Massachusetts Institute of Technology
United States, Boston
Harvard Medical School
United States, Chevy Chase
Howard Hughes Medical Institute
Essex, Max E.
United States, Boston
Harvard T.h. Chan School of Public Health Aids Initiative
Botswana, Gaborone
Botswana Harvard Aids Institute Partnership
Statistics
Citations: 63
Authors: 9
Affiliations: 6
Identifiers
Doi:
10.1097/QAD.0b013e3283471eb2
e-ISSN:
14735571
Research Areas
Infectious Diseases
Study Design
Cohort Study
Study Locations
Botswana
South Africa