Undetectable plasma viral load predicts normal survival in HIV-2-infected people in a West African village

被引：66

作者：

van der Loeff, Maarten F. Schim ^{[1
]}

Larke, Natasha ^{[2
]}

Kaye, Steve ^{[1
]}

Berry, Neil ^{[3
]}

Ariyoshi, Koya ^{[4
]}

Alabi, Abraham ^{[1
]}

van Tienen, Carla ^{[1
]}

Leligdowicz, Aleksandra ^{[1
]}

Sarge-Njie, Ramu ^{[1
]}

da Silva, Zacharias ^{[5
]}

Jaye, Assan ^{[1
]}

Ricard, Dominique ^{[1
]}

Vincent, Tim ^{[5
]}

Jones, Sarah Rowland ^{[1
]}

Aaby, Peter ^{[5
]}

Jaffar, Shabbar ^{[2
]}

Whittle, Hilton ^{[1
]}

机构：

[1] MRC Labs Fajara, Banjul, Gambia

[2] London Sch Hyg & Trop Med, Dept Epidemiol & Populat Hlth, London WC1E 7HT, England

[3] Natl Inst Biol Stand & Controls HPA, Div Retrovirol, S Mimms, Herts, England

[4] Nagasaki Univ, Dept Clin Med, Inst Trop Med, Nagasaki 852, Japan

[5] Indepth Network, Bandim Hlth Project, Bissau, Guinea Bissau

来源：

RETROVIROLOGY | 2010年 / 7卷

基金：

英国医学研究理事会;

关键词：

CD4 CELL PERCENTAGE; GUINEA-BISSAU; HIV-2; INFECTION; DUAL INFECTIONS; RURAL AREA; RNA LEVELS; MORTALITY; COHORT; GAMBIA; TRANSMISSION;

D O I：

10.1186/1742-4690-7-46

中图分类号：

Q93 [微生物学];

学科分类号：

071005 ; 100705 ;

摘要：

Background: There have been no previous studies of the long-term survival and temporal changes in plasma viral load among HIV-2 infected subjects. Methods: 133 HIV-2 infected and 158 HIV-uninfected subjects from a rural area in North-west Guinea-Bissau, West Africa were enrolled into a prospective cohort study in 1991 and followed-up to mid-2009. Data were collected on four occasions during that period on HIV antibodies, CD4% and HIV-2 plasma viral load. Results: Median age (interquartile range [IQR]) of HIV-2 infected subjects at time of enrollment was 47 (36, 60) years, similar to that of HIV-uninfected control subjects, 49 (38, 62) (p = 0.4). Median (IQR) plasma viral load and CD4 percentage were 347 (50, 4,300) copies/ml and 29 (22, 35) respectively. Overall loss to follow-up to assess vital status was small, at 6.7% and 6.3% for HIV-2 infected and uninfected subjects respectively. An additional 17 (12.8%) and 16 (10.1%) of HIV-2 infected and uninfected subjects respectively were censored during follow-up due to infection with HIV-1. The mortality rate per 100 person-years (95% CI) was 4.5 (3.6, 5.8) among HIV-2 infected subjects compared to 2.1 (1.6, 2.9) among HIV-uninfected (age-sex adjusted rate ratio 1.9 (1.3, 2.8, p < 0.001) representing a 2-fold excess mortality rate associated with HIV-2 infection. Viral load measurements were available for 98%, 78%, 77% and 61% HIV-2 infected subjects who were alive and had not become super-infected with HIV-1, in 1991, 1996, 2003 and 2006 respectively. Median plasma viral load (RNA copies per ml) (IQR) did not change significantly over time, being 150 (50, 1,554; n = 77) in 1996, 203 (50, 2,837; n = 47) in 2003 and 171 (50, 497; n = 31) in 2006. Thirty seven percent of HIV-2 subjects had undetectable viraemia (< 100 copies/ml) at baseline: strikingly, mortality in this group was similar to that of the general population. Conclusions: A substantial proportion of HIV-2 infected subjects in this cohort have stable plasma viral load, and those with an undetectable viral load (37%) at study entry had a normal survival rate. However, the sequential laboratory findings need to be interpreted with caution given the number of individuals who could not be re-examined.

引用

页数：10

共 30 条

[21] Maternal plasma viral RNA levels determine marked differences in mother-to-child transmission rates of HIV-1 and HIV-2 in The Gambia [J].