Characterization of Acute HIV-1 Infection in High-Risk Nigerian Populations

被引:19
作者
Charurat, Man [1 ]
Nasidi, Abdulsalami [2 ,3 ]
Delaney, Kevin [4 ]
Saidu, Ahmed [2 ]
Croxton, Taelisha
Mondal, Prosanta
Aliyu, Gambo Gumel
Constantine, Niel
Abimiku, Alash'le
Carr, Jean K.
Vertefeuille, John [5 ]
Blattner, William
机构
[1] Univ Maryland, Sch Med, Div Epidemiol & Prevent, Inst Human Virol, Baltimore, MD 21201 USA
[2] Nigerian Fed Minist Hlth, Abuja, Federal Capital, Nigeria
[3] Reach Care Fdn, Abuja, Federal Capital, Nigeria
[4] Ctr Dis Control & Prevent, Div HIV AIDS Prevent, Atlanta, GA USA
[5] Ctr Dis Control & Prevent, Global AIDS Program, Natl Ctr HIV AIDS Hepatitis STD & TB Prevent, Atlanta, GA USA
基金
美国国家卫生研究院;
关键词
IMMUNODEFICIENCY-VIRUS TYPE-1; T-CELL COUNTS; ANTIRETROVIRAL THERAPY; SUBTYPE; IDENTIFICATION; TRANSMISSION; INDIVIDUALS; DYNAMICS; AFRICA; LOAD;
D O I
10.1093/infdis/jis103
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background. Acute phase of human immunodeficiency virus (HIV) infection (AHI) may account for a significant proportion of HIV-1 transmission. We identified and characterized individuals in Nigeria with AHI. Methods. Individuals were tested using a combination of rapid HIV testing in mobile units and laboratory-based specimen pooling for nucleic acid amplification testing. Genome sequences were characterized. A linear segmented regression model was fit to serial viral load (VL) measurements to characterize early VL profiles. Results. Sixteen AHIs were identified from 28 655 persons screened. Specimens were genotyped: 7 (43.8%) were CRF02_AG, 6 (37.5%) were subtype G, 1 (6.3%) was CRF06_cpx, and 2 (12.5%) were unique recombinant forms. No antiretroviral resistance mutations were detected. The mean duration of high VL burden from peak to nadir was 76 days (95% confidence interval [CI], 58-93 days), and the mean rate of viremic control was -0.66 log(10) VL per month. The mean VL at set-point was 4.5 log(10) copies/mL (95% CI, 3.9-5.1 log(10) copies/mL). Conclusions. This study is the first to characterize AHI among Nigerians identified as HIV infected before seroconversion who would be otherwise missed by conventional HIV testing. Infections by HIV subtypes in Nigeria exhibit long periods of high viral burden, which can contribute to increased transmissibility.
引用
收藏
页码:1239 / 1247
页数:9
相关论文
共 27 条
[1]   Genotypic and phenotypic analyses of human immunodeficiency virus type 1 in antiretroviral drug-naive Nigerian patients [J].
Agwale, SM ;
Zeh, C ;
Paxinos, E ;
Odama, L ;
Pienazek, D ;
Wambebe, C ;
Kalish, ML ;
Ziermann, R .
AIDS RESEARCH AND HUMAN RETROVIRUSES, 2006, 22 (01) :22-26
[2]   Molecular surveillance of HIV-1 field strains in Nigeria in preparation for vaccine trials [J].
Agwale, SM ;
Zeh, C ;
Robbins, KE ;
Odama, L ;
Saekhou, A ;
Edubio, A ;
Njoku, M ;
Sani-Gwarzo, N ;
Gboun, MS ;
Gao, F ;
Reitz, M ;
Hone, D ;
Pieniazek, D ;
Wambebe, C ;
Kalish, ML .
VACCINE, 2002, 20 (16) :2131-2139
[3]   Rapid clearance of virus after acute HIV-1 infection: Correlates of risk of AIDS [J].
Blattner, WA ;
Oursler, KA ;
Cleghorn, F ;
Charurat, M ;
Sill, A ;
Bartholomew, C ;
Jack, N ;
O'Brien, T ;
Edwards, J ;
Tomaras, G ;
Weinhold, K ;
Greenberg, M .
JOURNAL OF INFECTIOUS DISEASES, 2004, 189 (10) :1793-1801
[4]   Characterization of subtype A HIV-1 from Africa by full genome sequencing [J].
Carr, JK ;
Laukkanen, T ;
Salminen, MO ;
Albert, J ;
Alaeus, A ;
Kim, B ;
Sanders-Buell, E ;
Birx, DL ;
McCutchan, FE .
AIDS, 1999, 13 (14) :1819-1826
[5]   A distinctive clade BHIV type 1 is heterosexually transmitted in Trinidad and Tobago [J].
Cleghorn, FR ;
Jack, N ;
Carr, JK ;
Edwards, J ;
Mahabir, B ;
Sill, A ;
McDanal, CB ;
Connolly, SM ;
Goodman, D ;
Bennetts, RQ ;
O'Brien, TR ;
Weinhold, KJ ;
Bartholomew, C ;
Blattner, WA ;
Greenberg, ML .
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 2000, 97 (19) :10532-10537
[6]   Amplified HIV transmission and new approaches to HIV prevention [J].
Cohen, MS ;
Pilcher, CD .
JOURNAL OF INFECTIOUS DISEASES, 2005, 191 (09) :1391-1393
[7]  
Constantine N., 2005, Retroviral testing and quality assurance: essentials for laboratory diagnosis
[8]   Dynamics of HIV viremia and antibody seroconversion in plasma donors: implications for diagnosis and staging of primary HIV infection [J].
Fiebig, EW ;
Wright, DJ ;
Rawal, BD ;
Garrett, PE ;
Schumacher, RT ;
Peddada, L ;
Heldebrant, C ;
Smith, R ;
Conrad, A ;
Kleinman, SH ;
Busch, MP .
AIDS, 2003, 17 (13) :1871-1879
[9]   Identification of inflections in T-cell counts among HIV-1-infected individuals and relationship with progression to clinical AIDS [J].
Gange, SJ ;
Munoz, A ;
Chmiel, JS ;
Donnenberg, AD ;
Kirstein, LM ;
Detels, R ;
Margolick, JB .
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA, 1998, 95 (18) :10848-10853
[10]   Viral dynamics and CD4+ T cell counts in subtype C human immunodeficiency virus type 1-infected individuals from southern Africa [J].
Gray, CM ;
Williamson, C ;
Bredell, H ;
Puren, A ;
Xia, XH ;
Filter, R ;
Zijenah, L ;
Cao, HY ;
Morris, L ;
Vardas, E ;
Colvin, M ;
Gray, G ;
McIntyre, J ;
Musonda, R ;
Allen, S ;
Katzenstein, D ;
Mbizo, M ;
Kumwenda, N ;
Taha, T ;
Karim, SA ;
Flores, J ;
Sheppard, HW .
AIDS RESEARCH AND HUMAN RETROVIRUSES, 2005, 21 (04) :285-291