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Natural control of HIV infection in young women in South Africa: HPTN 068.

Abstract：

BACKGROUND:Some individuals control HIV replication without antiretroviral (ARV) therapy. OBJECTIVE:To analyze viral suppression in young women in rural South Africa enrolled in a trial evaluating a behavioral intervention for HIV prevention. METHODS:Plasma samples were obtained from women ages 13-24 (81 infected at enrollment, 164 seroconverters). ARV testing was performed using an assay that detects 20 ARV drugs. Women were classified as viremic controllers if they were virally suppressed for ≥12 months with no ARV drug use. RESULTS:Samples from 216/245 (88.2%) women had no ARV drugs detected at their first HIV-positive visit. Thirty-four (15.7%) of the 216 women had a viral load <2,000 copies/mL. Fifteen of the 34 women were followed for ≥12 months; 12 were virally suppressed with no ARV drugs detected during follow-up. These women were classified as viremic controllers (overall: 12/216 = 5.6%). The median CD4 cell count at the first HIV-positive visit was higher among the 12 controllers than among the 204 women who were not using ARV drugs (759 vs. 549 cells/mm3, p = 0.02). Some women had a viral load <40 copies/mL at a single study visit, but none were classified as elite controllers (viral load <40 copies/mL for ≥12 months with no ARV drug use). CONCLUSIONS:In this cohort, 5.6% of women who were not using ARV drugs had sustained viral suppression. This represents a minimum estimate of the frequency of viremic controllers in this cohort, since some women were not followed long enough to meet the criteria for classification.

journal_name

HIV Clin Trials

journal_title

HIV clinical trials

authors

Sivay MV,Fogel JM,Wang J,Zhang Y,Piwowar-Manning E,Clarke W,Breaud A,Blankson J,Hamilton EL,Kahn K,Selin A,Gomez-Olive FX,MacPhail C,Hughes JP,Pettifor A,Eshleman SH

doi

10.1080/15284336.2018.1531534

subject

Has Abstract

pub_date

2018-10-01 00:00:00

pages

202-208

issue

5

eissn

1528-4336

issn

1945-5771

journal_volume

19

pub_type

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