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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Plasma and cervical viral loads among Ugandan and Zimbabwean women during acute and early HIV-1 infection
AIDS, Volume 24, No. 4, Year 2010
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Description
Objectives: High levels of HIV-1 viremia exist in peripheral blood during acute and early infection; however, data on HIV-1 viral loads in female genital secretions during this period are sparse. Design: Prospective cohort of 188 African women with primary HIV-1 infection. Methods: HIV-uninfected and infected women were followed quarterly; we tested serial plasma specimens by HIV PCR to estimate infection dates. We used the Loess procedure to estimate the magnitude and timing of viral setpoints in plasma and cervical secretions and generalized estimating equations (GEE) to identify predictors of plasma and cervical viral setpoints. Results: We estimated the mean HIV-1 plasma setpoint to be 4.20 log10 HIV-1 RNA copies/ml [95% confidence interval (CI) 4.04-4.35] at 121 days (95% CI 91-137) from infection; an analogous mean cervical viral setpoint was 1.64 log10 HIV-1 RNA copies/swab (95% CI 1.46-1.82) at 174 days (95% CI 145-194) from infection. Cervical loads were significantly higher (0.7-1.1 log10 copies/swab) during acute infection than subsequently. Subtype D infection, pregnancy, breastfeeding, and older age at the time of infection were associated with higher plasma viral setpoint. Subtype C infection, nonviral sexually transmitted infections, having a partner spending nights away from home, recent unprotected sex, and shorter time since infection were associated with higher cervical HIV-1 loads. Hormonal contraception was not associated with either the HIV-1 plasma setpoint or cervical loads during early infection. Conclusion: Cervical HIV-1 viral loads were highest during acute infection and then declined up to 6 months following infection, when a 'setpoint' was attained. The prognostic value of a cervical 'setpoint' on future transmission risk remains unclear. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Authors & Co-Authors
Morrison, Charles S.
United States, Research Triangle Park
Behavioral and Biomedical Research Department
Demers, Korey R.
United States, Philadelphia
University of Pennsylvania
Kwok, Cynthia
United States, Research Triangle Park
Biostatistics Department
Bulime, Stanley
Uganda, Kampala
Joint Clinical Research Center Uganda
Rinaldi, Anne
United States, Research Triangle Park
Behavioral and Biomedical Research Department
Munjoma, Marshall Wesley
Zimbabwe, Harare
University of Zimbabwe
Dunbar, Megan S.
United States, Research Triangle Park
Rti International
Chipato, Tsungai
Zimbabwe, Harare
University of Zimbabwe
Byamugisha, Josaphat Kayogoza
Uganda, Kampala
Makerere University
van der Pol, Barbara J.
United States, Indianapolis
Indiana University School of Medicine
Arts, Eric J.
United States, Cleveland
Case Western Reserve University
Salata, Robert A.
United States, Cleveland
Case Western Reserve University
Statistics
Citations: 89
Authors: 12
Affiliations: 9
Identifiers
Doi:
10.1097/QAD.0b013e32833433df
e-ISSN:
14735571
Research Areas
Infectious Diseases
Maternal And Child Health
Sexual And Reproductive Health
Study Design
Cohort Study
Participants Gender
Female