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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
general
Impact of CD4 and CD8 dynamics and viral rebounds on loss of virological control in HIV controllers
PLoS ONE, Volume 12, No. 4, Article e0173893, Year 2017
Notification
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Description
Objective: HIV controllers (HICs) spontaneously maintain HIV viral replication at low level without antiretroviral therapy (ART), a small number of whom will eventually lose this ability to control HIV viremia. The objective was to identify factors associated with loss of virological control. Methods: HICs were identified in COHERE on the basis of ≥5 consecutive viral loads (VL) ≤500 copies/mL over ≥1 year whilst ART-naive, with the last VL ≤500 copies/mL measured ≥5 years after HIV diagnosis. Loss of virological control was defined as 2 consecutive VL >2000 copies/mL. Duration of HIV control was described using cumulative incidence method, considering loss of virological control, ART initiation and death during virological control as competing outcomes. Factors associated with loss of virological control were identified using Cox models. CD4 and CD8 dynamics were described using mixed-effect linear models. Results: We identified 1067 HICs; 86 lost virological control, 293 initiated ART, and 13 died during virological control. Six years after confirmation of HIC status, the probability of losing virological control, initiating ART and dying were 13%, 37%, and 2%. Current lower CD4/CD8 ratio and a history of transient viral rebounds were associated with an increased risk of losing virological control. CD4 declined and CD8 increased before loss of virological control, and before viral rebounds. Discussion: Expansion of CD8 and decline of CD4 during HIV control may result from repeated low-level viremia. Our findings suggest that in addition to superinfection, other mechanisms, such as low grade viral replication, can lead to loss of virological control in HICs. © 2017 Chereau et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Authors & Co-Authors
Chereau, Fanny
France, Gif-sur-yvette
Université Paris-saclay
Madec, Yoann
France, Paris
Institut Pasteur, Paris
Sabin, Caroline Anne
United Kingdom, London
University College London
United Kingdom
Uk Chic
Obel, Niels
Denmark, Copenhagen
Rigshospitalet
Denmark
Danish Hiv Cohort
Chrysos, Georgios
Greece, Piraeus
Tzanion General Hospital
Fidler, Sarah J.
United Kingdom, London
Imperial College London
Lehmann, Clara
Germany, Koln
Universität zu Köln
Zangerle, Robert
Austria, Innsbruck
Medizinische Universitat Innsbruck
Wittkop, Linda
France, Talence
Centre Hospitalier Universitaire de Bordeaux
France
Anrs Co13 Hepavih
France, Bordeaux
Bordeaux Regional Coordinating Centre
Reiss, Peter
Netherlands, Amsterdam
Stichting Hiv Monitoring
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Hamouda, Osamah
Germany, Berlin
Robert Koch Institute
Germany
German Clinsurv
Estrada, Vicente P.
Spain, Madrid
Hospital Clínico San Carlos
Leal, Manuel Almudena
Spain, Madrid
Consejo Superior de Investigaciones Científicas
Mocroft, Amanda J.
United Kingdom, London
University College London
Denmark, Copenhagen
Eurosida
García-De-Olalla, Patrícia
Spain, Madrid
Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública
Ammassari, Adriana
Italy, Rome
Irccs Istituto Nazionale Malattie Infettive Lazzaro Spallanzani
Monforte, Antonella D’Arminio
Italy, Milan
Università Degli Studi Di Milano
United States
Icona
Mussini, Cristina
Italy, Modena
Università Degli Studi Di Modena e Reggio Emilia
Castagna, Antonella
Italy, Milan
Università Vita-salute San Raffaele
Cavassini, Matthias
Switzerland, Lausanne
Université de Lausanne Unil
Grabar, Sophie G.
France, Paris
Sorbonne Université
Morlat, Philippe
France, Talence
Centre Hospitalier Universitaire de Bordeaux
de Wit, Stéphane A.
Belgium, Brussels
Université Libre de Bruxelles
Belgium, Brussels
Centre Hospitalier Universitaire Saint Pierre, Brussels
Lambotte, Olivier
France, Fontenay-aux-roses
Immunologie Des Maladies Virales, Auto-immunes, Hematologiques et Bacteriennes
France, Gif-sur-yvette
Institut Des Maladies Emergentes et Des Thérapies Innovantes
France, Le Kremlin-bicetre
Hopital de Bicetre
Meyer, Laurence J.
France, Gif-sur-yvette
Université Paris-saclay
France
Anrs Co2 Seroco
Judd, Ali M.
Unknown Affiliation
Touloumi, Giota
United States, New York
Amacs
Warszawski, Josiane
Unknown Affiliation
Dabis, Franćois Ç.Ois
France
Anrs Co3 Aquitaine
Krause, Murielle Mary
France
Anrs Co4 Fhdh
Ghosn, Jade
France
Anrs Co6 Primo
Leport, Catherine
France
Anrs Co8 Copilote
Wit, Ferdinand W.N.M.
Unknown Affiliation
Prins, Maria
Unknown Affiliation
Bucher, Heíner C.C.
Unknown Affiliation
Gibb, Diana M.
Unknown Affiliation
Fätkenheuer, Gerd
Unknown Affiliation
del Amo, Julia
United Kingdom
Coris
Thorne, Claire N.
Unknown Affiliation
Kirk, Ole
Denmark, Copenhagen
Eurosida
Stephan, Christoph J.
Unknown Affiliation
Pérez-Hoyos, Santiago
Unknown Affiliation
Gunsenheimer-Bartmeyer, Barbara
Germany
German Clinsurv
Chkhartishvili, Nikoloz I.
United States
Georgian National Hiv/aids
Noguera-Julián, Antoni Diez
Denmark
Corispe-cat
Antinori, Andrea
Unknown Affiliation
Brockmeyer, Norbert Hermann
Poland
Kompnet
Prieto, Luis Alberto
Spain, Madrid
Madrid Pmtct Cohort
Conejo, Pablo Rojo
Spain, Madrid
Corispes-madrid
Soriano-Arandes, Antoni
Spain
Nenexp
Battegay, Manuel
Unknown Affiliation
Kouyos, Roger D.
Unknown Affiliation
Tookey, Pat A.
United Kingdom
Nshpc
Casabona, Jordi
Unknown Affiliation
Miró, José María
Unknown Affiliation
Konopnick, Deborah
Unknown Affiliation
Goetghebuer, Tessa
Unknown Affiliation
Sönnerborg, Anders B.
Sweden
Swedish Infcare
Torti, Carlo
Italy
Italian Master Cohort
Teira, Ramón M.
Germany
Vach
Garrido, Myriam
Germany
Vach
Haerry, David Hans Ulrich
Belgium, Brussels
European Aids Treatment Group
Miró, Josep Ma
Unknown Affiliation
Costagliola, Dominique G.
Unknown Affiliation
D'Arminio Monforte, Antonella D.
United States
Icona
Raben, Dorthe
Denmark, Copenhagen
Copenhagen Regional Coordinating Centre
Chêne, Geneviève
France, Bordeaux
Bordeaux Regional Coordinating Centre
Barger, Diana
France, Bordeaux
Bordeaux Regional Coordinating Centre
Schwimmer, Christine
France, Bordeaux
Bordeaux Regional Coordinating Centre
Termote, Monique
France, Bordeaux
Bordeaux Regional Coordinating Centre
Campbell, Maria Athena
Denmark, Copenhagen
Copenhagen Regional Coordinating Centre
Frederiksen, Casper M.
Denmark, Copenhagen
Copenhagen Regional Coordinating Centre
Friis-Möller, Nina
Denmark, Copenhagen
Copenhagen Regional Coordinating Centre
Kjaer, Jesper
Denmark, Copenhagen
Copenhagen Regional Coordinating Centre
Brandt, Rikke Salbøl
Denmark, Copenhagen
Copenhagen Regional Coordinating Centre
Berenguer, Juan J.
Unknown Affiliation
Bohlius, Julia
Unknown Affiliation
Bouteloup, Vincent
Unknown Affiliation
Cozzi-Lepri, Alessandro
Unknown Affiliation
Davies, M. A.
Unknown Affiliation
Dorrucci, Maria
Unknown Affiliation
Dunn, David T.
Unknown Affiliation
Egger, Matthias
Unknown Affiliation
Furrer, Hansjakob
Unknown Affiliation
Guiguet, Marguerite
Unknown Affiliation
Leroy, Valeriane
Unknown Affiliation
Lodi, Sara
Unknown Affiliation
Matheron, Sophie
Unknown Affiliation
Monge, Susana
Unknown Affiliation
Nakagawa, Fumiyo
Unknown Affiliation
Paredes, Roger
Unknown Affiliation
Phillips, Andrew N.
Unknown Affiliation
Puoti, Massimo
Unknown Affiliation
Rohner, Eliane
Unknown Affiliation
Schomaker, Michael
Unknown Affiliation
Smit, Colette
Unknown Affiliation
Sterne, Jonathan A.C.
Unknown Affiliation
Thíébaut, Rodolphe
Unknown Affiliation
van der Valk, Marc
Unknown Affiliation
Statistics
Citations: 30
Authors: 99
Affiliations: 53
Identifiers
Doi:
10.1371/journal.pone.0173893
ISSN:
19326203
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Cohort Study