Viral Load and CD4(+) T-Cell Dynamics in Primary HIV-1 Subtype C Infection
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Author list: Novitsky V, Woldegabriel E, Kebaabetswe L, Rossenkhan R, Mlotshwa B, Bonney C, Finucane M, Musonda R, Moyo S, Wester C, van Widenfelt E, Makhema J, Lagakos S, Essex M
Publisher: Lippincott, Williams & Wilkins
Place: PHILADELPHIA
Publication year: 2009
Journal: Journal of Acquired Immune Deficiency Syndromes (1525-4135)
Journal acronym: JAIDS-J ACQ IMM DEF
Volume number: 50
Issue number: 1
Start page: 65
End page: 76
Number of pages: 12
ISSN: 1525-4135
eISSN: 1944-7884
Languages: English-Great Britain (EN-GB)
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Abstract
Background: Most knowledge of primary HIV-1 infection is based on subtype B studies, whereas the evolution of viral parameters in the early phase of HIV-1 subtype C infection is not well characterized.Methods: The kinetics of viral RNA, proviral DNA, CD4(+) T-cell Count, and subsets of CD4(+) T cells expressing CCR5 or CXCR4 were characterized in 8 acute and 62 recent subtype C infections over the first year postseroconversion.Results: The viral RNA peak was 6.25 +/- 0.92 log (10) copies per milliliter. After seroconversion, heterogeneity among acute cases was evident by patterns of change in viral load and CD4(+) T-cell count over time. The patterns were supported by the rate of viral RNA decline from peak (P = 0.022), viral RNA means (P = 0.005), CD4 levels (P < 0.001). and CD4 decline to 350 (P = 0.011) or 200 (P = 0.046). Proviral DNA had no apparent peak and its mean was 2.59 +/- 0.69 log(10) per 106 peripheral blood mononuclear cell. In recent infections, vital RNA set point was 4.00 +/- 0.97 log(10) and viral RNA correlated inversely with CD4(+) T cells (P < 0.001) and directly with proviral DNA (P < 0.001).Conclusions: Distinct patterns of viral RNA evolution may exist shortly after seroconversion in HIV-1 subtype C infection. The study provides better understanding of the early phase of subtype C infection.
Keywords
acute HIV-1 infection, CD4 count, HIV-1 subtype C, natural history, primary HIV-1 infection, viral load
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