Viral load and CD4+ T-cell dynamics in primary HIV-1 subtype C infection.
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 log10 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 log10 per 106 peripheral blood mononuclear cell. In recent infections, viral RNA set point was 4.00 +/- 0.97 log10 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.
Novitsky
Vladimir
V
Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA 02115, USA.
Woldegabriel
Elias
E
Kebaabetswe
Lemme
L
Rossenkhan
Raabya
R
Mlotshwa
Busisiwe
B
Bonney
Caitlin
C
Finucane
Mariel
M
Musonda
Rosemary
R
Moyo
Sikhulile
S
Wester
Carolyn
C
van Widenfelt
Erik
E
Makhema
Joseph
J
Lagakos
Stephen
S
Essex
M
M
D000328:Adult; D001902:Botswana / Q000453:epidemiology; D018791:CD4 Lymphocyte Count / Q000639:trends*; D015331:Cohort Studies; D004279:DNA, Viral / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000276:immunology / Q000821:virology*; D015497:HIV-1 / Q000145:classification* / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D012367:RNA, Viral / Q000097:blood; D013997:Time Factors; D019562:Viral Load; D055815:Young Adult
D004279:DNA, Viral; D012367:RNA, Viral