Recent HIV-1 infection: identification of individuals with high viral load setpoint in a voluntary counselling and testing centre in rural Mozambique.
Recent HIV-1 infection: identification of individuals with high viral load setpoint in a voluntary counselling and testing centre in rural Mozambique.
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DOI：
10.1371/journal.pone.0031859
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Naniche D
中科院分区：
文献类型：
--
作者：
Serna-Bolea C;de Deus N;Acácio S;Muñoz J;Nhalungo D;Letang E;Alonso P;Naniche D
确定最近的艾滋病毒感染对于描述艾滋病毒流行和为今后的艾滋病毒干预试验汇编艾滋病毒rna设定值数据非常重要。我们在莫桑比克南部的一个自愿咨询和检测中心（VCT）进行了一项研究，以描述最近的感染情况和成年人群中的hiv - rna设定点。2009年4月至10月期间参加曼西帕拉区医院VCT的所有成年人都被招募，如果他们至少有一项快速艾滋病毒血清学检测阳性。通过BED-CEIA hiv感染率检测筛查患者近期HIV-1感染情况。在入组、4个月和10个月时进行临床检查，评估HIV-RNA和CD4细胞计数。在本研究纳入的492名参与者中，BED-CEIA测试定义的近期感染患病率为11.58% (57/492;95% CI 8.89-14.74)， CD4计数为200个细胞/µl， HIV-RNA计数为400拷贝/mL。由于近期感染患者HIV-RNA水平的异质性，如果诊断时HIV-RNA水平高于中位数（4.98 log10拷贝/mL），则个体被归类为“高”HIV-RNA载量。“高”HIV-RNA组在所有就诊时的hiv病毒载量都显著较高，HIV-RNA设定点中位数为5.22 log10 copies/mL (IQR 5.18-5.47)，而其他患者的中位数为4.15 log10 copies/mL (IQR 3.37-4.43) （p = 0.0001）。在艾滋病毒血清检测呈阳性的VCT患者中，近期感染艾滋病毒的比例较低，这表明这一人群中的大多数在艾滋病毒/艾滋病晚期才进行VCT检测。HIV- rna设定点的特征可能有助于确定维持HIV病毒载量为0.5 log10拷贝/mL的新近感染个体作为抗逆转录病毒治疗作为预防干预措施的候选者。
Identification of recent HIV-infections is important for describing the HIV epidemic and compiling HIV-RNA-setpoint data for future HIV intervention trials. We conducted a study to characterize recent infections, and HIV-RNA-setpoint within the adult population presenting at a voluntary counselling and testing centre (VCT) in southern Mozambique. All adults attending the Manhiça District-Hospital VCT between April and October 2009 were recruited if they had at least one positive rapid HIV-serology test. Patients were screened for recent HIV-1 infection by BED-CEIA HIV-incidence test. Clinical examination, assessment of HIV-RNA and CD4 cell counts were performed at enrollment, 4 and 10 months. Of the 492 participants included in this study, the prevalence of recent infections as defined by BED-CEIA test, CD4 counts >200 cells/µl and HIV-RNA >400 copies/mL, was 11.58% (57/492; 95% CI 8.89–14.74). Due to heterogeneity in HIV-RNA levels in recently infected patients, individuals were categorized as having “high” HIV-RNA load if their HIV-RNA level was above the median (4.98 log10 copies/mL) at diagnosis. The “high” HIV-RNA group sustained a significantly higher HIV-viral load at all visits with a median HIV-RNA setpoint of 5.22 log10 copies/mL (IQR 5.18–5.47) as compared to the median of 4.15 log10 copies/ml (IQR 3.37–4.43) for the other patients (p = 0.0001). The low proportion of recent HIV-infections among HIV-seropositive VCT clients suggests that most of this population attends the VCT at later stages of HIV/AIDS. Characterization of HIV-RNA-setpoint may serve to identify recently infected individuals maintaining HIV viral load>5 log10 copies/mL as candidates for antiretroviral treatment as prevention interventions.
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