Plasma and cervical viral loads among Ugandan and Zimbabwean women during acute and early HIV-1 infection

Morrison, Charles; Demers, Korey; Kwok, Cynthia; Bulime, Stanley; Rinaldi, Anne; Munjoma, Marshall; Dunbar, Megan; Chipato, Tsungai; Byamugisha, Josaphat; Pol, Barbara Van Der; Arts, Eric J.; Salata, Robert A.

doi:10.1097/qad.0b013e32833433df

Cited by 82 publications

(98 citation statements)

References 43 publications

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“…These results are consistent with HIV-RNA being present in CVS within 1 week after exposure ( Figure 3B), suggesting that local HIV replication occurs in the FRT and/or CVS followed by the establishment of systemic infection in all mice by 2 weeks after exposure ( Figure 3B). Especially noteworthy is the timing of viral shedding into CVS after vaginal exposure, which is characterized by an early peak in viremia followed by a gradual decline (Figure 3B) that mimics the HIV genital shedding profile observed in CVS of women during acute HIV infection (39). Notably, we also observed an increase in CD8 + T cells in CVS after vaginal infection ( Figure 5A).…”

Section: Discussionsupporting

confidence: 56%

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ART influences HIV persistence in the female reproductive tract and cervicovaginal secretions

Olesen

Swanson

Kovářová

et al. 2016

Journal of Clinical Investigation

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Section: Discussionsupporting

confidence: 56%

“…As seen in humans, there was an overall significant positive linear correlation between the viral load in plasma and CVS (Spearman's correlation coefficient = 0.55 [95% CI, 0.36-0.69, P < 0.001, n = 51]) (Figure 3E and refs. 31,(39)(40)(41)(42).…”

Section: Reconstitution Of the Frt Of Blt Mice With Human Cd4mentioning

confidence: 99%

ART influences HIV persistence in the female reproductive tract and cervicovaginal secretions

Olesen

Swanson

Kovářová

et al. 2016

Journal of Clinical Investigation

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“…Recent evaluation of 188 women enrolled in a cohort in sub-Saharan Africa identified those with acute or early-stage infection. Viral loads in cervical secretions were significantly higher during acute infection before declining to a lower set-point 6 months after infection [48]. Transmission of HIV is enhanced during this period of high viral load, and analysis of the Rakai cohort data identified early and late periods of HIV infection were associated with highest risk of transmission per coital act (8.2/1000 within 2.5 months of seroconversion, diminishing to 0.7/1000 during established infection, and then climbing to 2.8/1000 within 6-24 months of death) [49].…”

Section: Role Of Acute Hiv Infection In Transmissionmentioning

confidence: 97%

Antiretroviral Therapy: A Key Component of a Comprehensive HIV Prevention Strategy

Hull

Montaner

2011

Curr HIV/AIDS Rep

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Transmission of HIV is critically dependent on the level of HIV viral load within blood and genital secretions. Antiretroviral therapy results in sustained reductions in viral load to undetectable levels. Thus, antiretroviral therapy has long been postulated as a potential means to curb HIV transmission. Observational data have now confirmed that antiretroviral therapy is associated with a decrease in transmission among heterosexual serodiscordant couples, injection-drug users, and in population-based studies. Mathematical models suggest that further expansion of antiretroviral coverage within current guidelines can play a major role in controlling the spread of HIV. Concerns regarding the potential for transmission during acute HIV infection, behavioral disinhibition, and resistance to overcome the impact of treatment on prevention have not materialized to date. The Joint United Nations AIDS (UNAIDS) program has called for the inclusion of antiretroviral treatment as a key pillar in the global strategy to control the spread of HIV infection.

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“…CD4 cell count and viral load data were reported previously. 18 HIV subtypes were determined previously based on phylogenetic analysis of the gp120 C2-V3 region of the HIV env gene. 17 The estimated date of seroconversion for each woman was defined as the midpoint between the last negative HIV antibody test and the first positive HIV antibody test, or 15 days after a visit documenting acute (HIV RNA-positive/antibody-negative) HIV infection.…”

Section: Study Populationmentioning

confidence: 99%

Comparison of Antibody Responses to HIV Infection in Ugandan Women Infected with HIV Subtypes A and D

Longosz

Morrison

Chen

et al. 2015

AIDS Research and Human Retroviruses

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We compared the serologic response to HIV infection in Ugandan women with HIV subtype A (N = 82) and D (N = 32) infection using a limiting antigen avidity assay (LAg-Avidity assay); 2,614 samples were analyzed. Study participants were followed a median of 6.6 years after HIV seroconversion. Samples were classified as assay positive if they had a LAg-Avidity assay result < 1.5 normalized optical density units (OD-n). Women with subtype D infection were more likely to have delayed antibody maturation. During the first 2 years after seroconversion, the mean time that women had an assay-positive result (mean duration of recent infection, MDRI) was longer for women with subtype D infection than women with subtype A infection (267.9 days, 95% CI: 231.2-308.2 vs. 167.3 days, 95% CI: 151.8-185.9 days, p < 0.01). The MDRI was also longer for women with subtype D infection after excluding low viral load samples and samples from women on antiretroviral therapy (ART). Women infected for > 2 years were also more likely to be misclassified as recently infected in they had subtype D infection. Women with subtype D infection were also more likely to have antibody waning compared to women with subtype A infection. These findings may be related to the higher pathogenicity of subtype D HIV infection and are relevant to use of the LAg-Avidity assay for cross-sectional HIV incidence estimation in populations where subtype D infection is prevalent.

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Plasma and cervical viral loads among Ugandan and Zimbabwean women during acute and early HIV-1 infection

Cited by 82 publications

References 43 publications

ART influences HIV persistence in the female reproductive tract and cervicovaginal secretions

ART influences HIV persistence in the female reproductive tract and cervicovaginal secretions

Antiretroviral Therapy: A Key Component of a Comprehensive HIV Prevention Strategy

Comparison of Antibody Responses to HIV Infection in Ugandan Women Infected with HIV Subtypes A and D

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