scholarly journals HIV-DNA undetectability during chronic HIV infection: frequency and predictive factors

2020 ◽  
Vol 75 (10) ◽  
pp. 2994-2997
Author(s):  
Silvia Nozza ◽  
Laura Galli ◽  
Nicola Gianotti ◽  
Mariarita Parisi ◽  
Andrea Poli ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Undetectable Viral Load ◽  
People Living With Hiv ◽  
Infection Frequency ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Infected People ◽  
Hiv Rna ◽  
Hiv Dna ◽  
Hiv 1

Abstract Background HIV-DNA is a marker of HIV reservoirs. Objectives of the study were to determine prevalence of HIV-DNA < 100 copies/106 PBMCs in blood and to identify factors associated with this in a cohort of HIV-1-infected subjects treated with ART and with undetectable viral load (VL). Methods This was a cross-sectional study on chronic HIV-1-infected people living with HIV (PLWH) followed up at the Department of Infectious Diseases of San Raffaele Scientific Institute on current ART without change for 12 months, with available pre-ART HIV-RNA and with undetectable VL for ≥12 months. HIV-DNA was amplified and quantified by real-time PCR (ABI Prism 7900); limit of detectability was 100 copies/106 PBMCs. Logistic regression was used to identify predictive factors for HIV-DNA < 100 copies/106 PBMCs. Results Four hundred and sixty-eight PLWH were considered in the analyses, 119 (25%) with HIV-DNA < 100 copies/106 PBMCs. At multivariate analysis, we found that PLWH with lower zenith HIV-RNA, higher nadir CD4 and a shorter time between HIV diagnosis and ART start were more likely to have HIV-DNA < 100 copies/106 PBMCs, after adjustment for age, gender, calendar year of ART start, type of current ART regimen, percentage time spent with undetectable VL since ART start, current CD4 and CD4/CD8 ratio. Conclusions In our chronic PLWH on virological suppression for 4 years, the prevalence of HIV-DNA < 100  copies/106 PBMCs was found to be 25%. Lower zenith HIV-RNA, shorter time between HIV diagnosis and starting ART and higher CD4 nadir were independently associated with low HIV-DNA.

scholarly journals Prolonged Post-Treatment Virologic Control and Complete Seroreversion after Advanced HIV-1 Infection

2020 ◽  
Author(s):  
Analia Uruena ◽  
Isabel Cassetti ◽  
Neena Kashyap ◽  
Claire Deleage ◽  
Jacob D Estes ◽  
...  
Keyword(s):  
T Cells ◽  
Lymph Node ◽  
Mononuclear Cells ◽  
Brain Biopsy ◽  
Post Treatment ◽  
Hiv Diagnosis ◽  
Hiv Reservoir ◽  
Hiv Rna ◽  
Hiv Dna ◽  
Hiv 1

Abstract Background Possible human immunodeficiency virus (HIV)-1 clearance has been rarely reported. Here we describe a unique case of an HIV-positive, combination antiretroviral therapy (cART)-experienced woman with prior acquired immunodeficiency syndrome (AIDS) who has not experienced viral rebound for over 12 years since discontinuing cART. Methods Leukapheresis, colonoscopy, and lymph node excision were performed for detailed examination of virologic (including HIV reservoir) and immunologic features. Comparisons were made with chronically infected patients and healthy controls. Results No HIV-specific antibodies were detected in serum. Plasma HIV RNA levels were <0.2 copies/mL and, except for low-frequency HIV DNA + cells in lymph node tissue (1 copy/3 x 10 6 cells), HIV antigen could not be detected by quantitative virus outgrowth (<0.0025 infectious units/10 6 CD4 + T cells) or by most measurements of HIV RNA or DNA in blood, lymph node or gut-associated mononuclear cells. HIV-specific T-cell responses were detectable, but low. Brain imaging revealed a prior biopsy site and persistent white matter disease since 1996. HIV DNA + cells in the 1996 brain biopsy specimen confirmed her identity and initial HIV diagnosis. Conclusions This represents the first report of complete seroreversion, prolonged post-treatment virus suppression, a profoundly small HIV reservoir and persistent HIV-specific T cells in an adult with prior AIDS.

Analytical treatment interruption in chronic HIV-1 infection: time and magnitude of viral rebound in adults with 10 years of undetectable viral load and low HIV-DNA (APACHE study)

2019 ◽  
Vol 74 (7) ◽  
pp. 2039-2046 ◽  
Author(s):  
Antonella Castagna ◽  
Camilla Muccini ◽  
Laura Galli ◽  
Alba Bigoloni ◽  
Andrea Poli ◽  
...  
Keyword(s):  
Viral Load ◽  
Undetectable Viral Load ◽  
Treatment Interruption ◽  
Viral Reservoir ◽  
Viral Rebound ◽  
Analytical Treatment ◽  
Hiv Rna ◽  
Hiv Dna ◽  
Acute Retroviral Syndrome ◽  
Hiv 1

AbstractObjectivesDespite the fact that there are individuals who have chronic HIV infection, few studies have investigated ART interruption in this setting. The aim of this study was to evaluate the ability to spontaneously control viral replication during analytical treatment interruption (ATI) in adults with chronic HIV-1 infection, on ART, with suppressed viraemia for >10 years and with a low reservoir.Patients and methodsThis was a prospective, open-label, single-arm, non-randomized, proof-of-concept study (NCT03198325) of subjects with chronic HIV-1 infection, HIV-RNA <50 copies/mL for ≥10 years, without residual viraemia for ≥5 years, CD4+ >500 cells/mm3, HIV-DNA <100 copies/106 PBMCs and without comorbidities or AIDS-defining diseases. Enrolled patients were strictly monitored. The ART regimen in use at ATI was resumed in the case of confirmed viral rebound (CVR, two consecutive HIV-RNA >50 copies/mL). Results are reported as median (IQR).ResultsNine patients underwent ATI. All participants experienced CVR [4.84 (IQR: 3.47–6.47) HIV-RNA log10 copies/mL] after ATI at a median time of 21 days (range 14–56) and restarted ART. After ART resumption, all the subjects achieved HIV-RNA <50 copies/mL in a median of 88 days (range 15–197). No serious adverse event occurred; one subject experienced acute retroviral syndrome. No significant correlation between baseline factors and time to viral rebound was observed, while the magnitude of viral rebound was significantly associated with pre-ART HIV-1 RNA (Spearman r = 0.786, P = 0.036), nadir CD4+ (Spearman r = −0.800, P = 0.010), baseline CD4+ (Spearman r = −0.667, P = 0.049) and years with undetectable viral load (Spearman r = −0.717, P = 0.030).ConclusionsDespite a long period of HIV viral load suppression and a low viral reservoir, early and consistent viral rebound was observed during ATI in all subjects.

scholarly journals Stigma mastery in people living with HIV: gender similarities and theory

2021 ◽  
Author(s):  
Charles Patrick Namisi ◽  
John C. Munene ◽  
Rhoda K. Wanyenze ◽  
Anne R. Katahoire ◽  
Rosalinda M. Parkes-Ratanshi ◽  
...  
Keyword(s):  
Older Women ◽  
Social Exclusion ◽  
Theoretical Framework ◽  
People Living With Hiv ◽  
Negative Effects ◽  
Hiv Diagnosis ◽  
Cross Sectional ◽  
Age Related ◽  
Related Stigma ◽  
Living With Hiv

Abstract Aims This study aimed to determine the prevalence of, factors associated with, and to build a theoretical framework for understanding Internalsed HIV-related Stigma Mastery (IHSM). Methods A cross-sectional study nested within a 2014 Stigma Reduction Cohort in Uganda was used. The PLHIV Stigma Index version 2008, was used to collect data from a random sample of 666 people living with HIV (PLHIV) stratified by gender and age. SPSS24 with Amos27 softwares were used to build a sequential-mediation model. Results The majority of participants were women (65%), aged ≥ 40 years (57%). Overall, IHSM was 45.5% among PLHIV, that increased with age. Specifically, higher IHSM correlated with men and older women “masculine identities” self-disclosure of HIV-diagnosis to family, sharing experiences with peers. However, lower IHSM correlated with feminine gender, the experience of social exclusion stress, fear of future rejection, and fear of social intimacy. Thus, IHSM social exclusion with its negative effects and age-related cognition are integrated into a multidimensional IHSM theoretical framework with a good model-to-data fit. Conclusion Internalised HIV-related Stigma Mastery is common among men and older women. Specificially, “masculine identities” self-disclose their own HIV-positive diagnosis to their family, share experiences with peers to create good relationships for actualising or empowerment in stigma mastery. However, social exclusion exacerbates series of negative effects that finally undermine stigma mastery by young feminine identities. Thus, stigma mastery is best explained by an integrated empowerment framework, that has implications for future practice, policy, and stigma-related research that we discuss.

High viremia and Poor Immunity are Potential Surrogates of Anti-toxoplasmic Immunoglobulin G Quantification among HIV-Infected Individuals: A Cross-sectional Study in Yaoundé, Cameroon

2020 ◽  
Author(s):  
Aude Christelle Ka'e ◽  
Samuel Martin Sosso ◽  
Joseph Fokam ◽  
Rachel Kamgaing Simo ◽  
Sara Riwom Essama ◽  
...  
Keyword(s):  
Opportunistic Infection ◽  
Immune Status ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Sectional Study ◽  
Cross Sectional ◽  
Reference Centre ◽  
Resource Limited ◽  
Common Opportunistic Infection ◽  
Hiv 1

Abstract Background: Toxoplasmosis remains a neglected common opportunistic infection in immunocompromised individuals, who are mainly people living with HIV (PLWHIV) in whom reactivation of toxoplasmosis may occur with advanced HIV conditions in resource-limited settings (RLS). Our objective was to evaluate the correlation between the anti-toxoplasmic IgG (Tg-IgG) concentration and the immuno-virological status of PLWHIV.Methods : A prospective and cross-sectional study was conducted among PLWHIV aged>18 years from February to November 2018 at the Chantal BIYA international Reference Centre. Blood samples were collected from eligible consenting PLWHIV; Tg-IgG level was assessed by quantitative ELISA, CD4-T lymphocytes counts were measured by flow cytometry and HIV-1 plasma viral load (PVL) measurement by real-time-PCR. Data were analysed using Excel and Graph Pad softwares; with p<0.05 considered statistically significant.Results : A total of 100 PLWHIV were enrolled: 56% seropositive for IgG anti- Toxoplasma gondii, 33% seronegative and 11% indeterminate results. According to viremia, 100% (19/19) of those with PVL>1000 copies/mL were seropositive to Tg-IgG versus 52.85% (37/70) of those with PVL<1000 copies/mL (median [IQR] IgG concentration 152.78 [139.24-444.43] versus 34.44 [13.04-36.47] IU/mL, respectively); p<0.0001. According to CD4, 100% (11/11) of those with T-CD4<200 cells/µL were seropositive to Tg-IgG versus 57.69% (45/78) of those with T-CD4>200 cells/µL (median IgG [IQR] 432.92 [145.06-450.47] versus 35.01 [15.01-38.01] IU/mL, respectively); p<0.0001. Interestingly, there were moderate-positive and strong-negative correlations respectively with HIV-1 PVL (r = 0.54; p<0.0001) and T-CD4 (r = -0.70; p<0.0001) as compared to Tg-IgG concentration. After adjusting for age, gender, immune status and PVL in logistic regression, only poor immune status (T-CD4<200 cells/µL) was independently associated to Tg-IgG seropositivity (p=0.0004).Conclusion : In a typical RLS like Cameroon, about half of PLWHIV might be seropositive to Tg-IgG. Of relevance, decreasing immunity appears with risk of increasing IgG anti- T gondii concentration, which suggests a relapse of toxoplasmosis. Thus, in the context of immunodeficiency, routine quantification of Tg-IgG would alleviate the programmatic burden of this opportunistic infection in RLS with generalized HIV epidemics.

scholarly journals First-line antiretroviral therapy and dyslipidemia in people living with HIV-1 in Cameroon: a cross-sectional study

2011 ◽  
Vol 8 (1) ◽  
pp. 33 ◽  
Author(s):  
Eric Pefura Yone ◽  
Awa Betyoumin ◽  
André Kengne ◽  
François Kaze Folefack ◽  
Jeanne Ngogang
Keyword(s):  
Antiretroviral Therapy ◽  
Cross Sectional Study ◽  
People Living With Hiv ◽  
Sectional Study ◽  
First Line ◽  
Cross Sectional ◽  
Living With Hiv ◽  
Hiv 1

scholarly journals Evaluation of the limiting antigen avidity EIA (LAg) in people who inject drugs in Greece

2016 ◽  
Vol 145 (2) ◽  
pp. 401-412 ◽  
Author(s):  
G. K. NIKOLOPOULOS ◽  
A. KATSOULIDOU ◽  
M. KANTZANOU ◽  
C. ROKKA ◽  
C. TSIARA ◽  
...  
Keyword(s):  
Optical Density ◽  
People Who Inject Drugs ◽  
Recombinant Form ◽  
Hiv Diagnosis ◽  
Hiv Rna ◽  
Avidity Assay ◽  
Window Period ◽  
Treatment Naïve ◽  
Hiv 1 ◽  
Similar Incidence

SUMMARYThis analysis assessed the utility of the limiting antigen avidity assay (LAg). Samples of people who inject drugs (PWID) in Greece with documented duration of HIV-1 infection were tested by LAg. A LAg-normalized optical density (ODn) ⩽1·5 corresponds to a recency window period of 130 days. The proportion true recent (PTR) and proportion false recent (PFR) were estimated in 28 seroconverters and in 366 samples collected >6 months after HIV diagnosis, respectively. The association between LAg ODn and HIV RNA level was evaluated in 232 persons. The PTR was 85·7%. The PFR was 20·8% but fell to 5·9% in samples from treatment-naive individuals with long-standing infection (>1 year), and to 0 in samples with the circulating recombinant form CRF35 AD. A LAg-based algorithm with a PFR of 3·3% estimated a similar incidence trend to that calculated by analyses based on HIV-1 seroconversions. In recently infected persons indicated by LAg, the median log10 HIV RNA level was high (5·30, interquartile range 4·56–5·90). LAg can help identify highly infectious HIV(+) individuals as it accurately identifies recent infections and is correlated with the HIV RNA level. It can also produce reliable estimates of HIV-1 incidence.

scholarly journals Thrombocytopenia according to antiretroviral drug combinations, viremia and CD4 lymphocytes among HIV-infected patients in Cameroon: a snapshot from the City of Yaoundé

2019 ◽  
Vol 12 (1) ◽  
Author(s):  
Alex Durand Nka ◽  
Samuel Martin Sosso ◽  
Joseph Fokam ◽  
Yagai Bouba ◽  
Georges Teto ◽  
...  
Keyword(s):  
Viral Load ◽  
Blood Platelets ◽  
Undetectable Viral Load ◽  
Drug Combinations ◽  
People Living With Hiv ◽  
Cross Sectional ◽  
Viral Loads ◽  
Reference Centre ◽  
Antiretroviral Drug ◽  
Load Rate

Abstract Objective Thrombocytopenia is an abnormal decrease in blood platelets, which can affect the prognosis of people living with HIV (PLHIV). In order to assess the burden of this haematological disorder, we evaluated the frequency of thrombocytopenia according to antiretroviral drug combinations, viremia and the immune status of PLHIV. Results A cross-sectional and analytical study was conducted from June to November 2016 among 310 PLHIV at the “Chantal BIYA” International Reference Centre, Yaoundé, Cameroon. Overall rate of thrombocytopenia was 19.0% (59/310). The rate of thrombocytopenia was 64.6% (42/65) versus 6.9% (17/245) in ART-naïve versus ART-treated patients respectively, p < 0.0001. Following viral load, rate of thrombocytopenia was 15.8% (20/130) in those with undetectable viral load, and 34.1% (27/79) with viral loads > 3 log10 RNA/ml (p = 0.03). As concerns CD4-count, rate of thrombocytopenia was 16.2% (42/259) in those with ≥ 200 CD4/mm3 versus 33.3% (17/51) with < 200 CD4/mm3 (p = 0.0003). After adjusting for sex, ART, viral load and CD4, Viral load and ART exposure were significantly associated with decreased risk of thrombocytopenia (p < 0.05). Thrombocytopenia occurs especially among ART-naïve, high viremia and severe immune-compromised patients. Interestingly, ART coverage appears as an independent factor in preventing the occurrence of thrombocytopenia.

scholarly journals 1265. Monitoring of Human Immunodeficiency Virus (HIV)-Infection Using the Cepheid HIV-1 Qualitative Assay

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S455-S455
Author(s):  
Erin Keizur ◽  
Drew Wood-Palmer ◽  
Maryann Koussa ◽  
Manuel Ocasio ◽  
Mary Jane Rotheram-Borus ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Los Angeles ◽  
Hiv Infection ◽  
Whole Blood ◽  
Viral Rna ◽  
Hiv Rna ◽  
Hiv Dna ◽  
Immunodeficiency Virus ◽  
Hiv 1 ◽  
Pcr Test

Abstract Background Human immunodeficiency virus (HIV)-1 RNA quantification is the primary method of monitoring response to antiretroviral therapy. In the U.S. viral RNA testing is recommended for all HIV-infected patients at entry into care, at initiation or modification of therapy, and on a regular basis thereafter. HIV-1 DNA testing may pose additional advantages. For example, proviral DNA may predict early loss of viral suppression. The Cepheid® (Sunnyvale, CA) HIV-1 Qualitative (HIV Qual) assay detects total nucleic acid for both RNA and DNA and provides a qualitative result (HIV detectable or undetectable). Methods We tested participants aged 14–24 years old from the Adolescent Trials Network (ATN) CARES study with known HIV infection in Los Angeles, California and New Orleans, Louisiana. We tested participants using the Cepheid® HIV Qual assay and the quantitative HIV-1 RNA, real-time PCR test using the COBAS P6800 system (Roche, Branchburg, NJ). We used 100 μL of whole blood for the HIV Qual assay and results were provided in 90 minutes. We sent the remainder of the whole blood from the same visit to a commercial laboratory for HIV-RNA PCR testing and results were reported as “detected,” “detected, <20 copies/mL plasma” or “not detected, <20 copies/mL plasma.” We compared HIV Qual and HIV RNA PCR test results from the same visit for each participant. Results Overall, 57 HIV Qual tests were performed with concurrent HIV RNA PCR tests. Of those, 9/15 tests were concordant with HIV viral RNA suppression while 39/42 tests were concordant with HIV viral RNA detection. In 6 cases, the HIV RNA was not detected at <20 copies/mL by the Roche PCR while the HIV Qual assay detected HIV DNA. Of those 6 cases, 3 had subsequent HIV RNA PCR testing. All 3 cases had detectable HIV RNA at their next testing date (214 copies/mL, detected <20 copies/mL, 2130 copies/mL). Conclusion The HIV Qual test is feasible for the monitoring of HIV-infection. Due to its detection of HIV DNA, it may predict future lack of HIV RNA suppression. Disclosures All authors: No reported disclosures.

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