title: Viral and host factors associated with the HIV-1 viral load setpoint in adults from Mbeya Region, Tanzania.
abstract: BACKGROUND
  The viral load setpoint (VLS) is an important predictor of HIV disease progression, but there is a lack of information regarding the VLS and its possible determinants in African populations.
  
  
  METHODS
  Initially HIV-negative adults from 3 distinct groups(female bar workers, females, and males from the general population)were followed for up to 4 years. The VLS was calculated for 108 seroconverters and associations of the VLS with possible risk factors were analyzed using univariate and multivariate regression.
  
  
  RESULTS
  The median VLS for female bar workers, females, and males from the general population were 69,850, 28,600, and 158,000 RNA copies per milliliter, respectively. Significant associations with an elevated viral load were observed for male gender [risk ratio(RR) = 1.83, 95% confidence interval (95% CI) = 1.14 to 2.93], the expression of harmful HLA I alleles (RR = 1.73, 95% CI = 1.13 to 2.66) and multiple infection with different HIV-1 subtypes (RR =1.65, 95% CI = 1.03 to 2.66). Bar workers were considerably more often infected with different HIV-1 subtypes than participants from the general population.
  
  
  CONCLUSIONS
  Our study confirms that gender and the expression of different HLA class I alleles are important determinants of the viremia at VLS, and it also corroborates an earlier finding that multiple infection with different HIV-1 subtypes is associated with a higher VLS.
authors.affiliation: Department of Infectious Diseases and Tropical Medicine, Ludwig-Maximilians-University of Munich (LMU), Munich, Germany. elmarsaathoff@web.de
authors.forename: Elmar
authors.initials: E
authors.lastname: Saathoff
authors.forename: Michael
authors.initials: M
authors.lastname: Pritsch
authors.forename: Christof
authors.initials: C
authors.lastname: Geldmacher
authors.forename: Oliver
authors.initials: O
authors.lastname: Hoffmann
authors.forename: Rebecca N
authors.initials: RN
authors.lastname: Koehler
authors.forename: Leonard
authors.initials: L
authors.lastname: Maboko
authors.forename: Lucas
authors.initials: L
authors.lastname: Maganga
authors.forename: Steffen
authors.initials: S
authors.lastname: Geis
authors.forename: Francine E
authors.initials: FE
authors.lastname: McCutchan
authors.forename: Gustavo H
authors.initials: GH
authors.lastname: Kijak
authors.forename: Jerome H
authors.initials: JH
authors.lastname: Kim
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Arroyo
authors.forename: Martina
authors.initials: M
authors.lastname: Gerhardt
authors.forename: Sodsai
authors.initials: S
authors.lastname: Tovanabutra
authors.forename: Merlin L
authors.initials: ML
authors.lastname: Robb
authors.forename: Carolyn
authors.initials: C
authors.lastname: Williamson
authors.forename: Nelson L
authors.initials: NL
authors.lastname: Michael
authors.forename: Michael
authors.initials: M
authors.lastname: Hoelscher
mesh_terms: D000293:Adolescent; D000328:Adult; D018791:CD4 Lymphocyte Count; D015331:Cohort Studies; D005260:Female; D005805:Genes, MHC Class I; D015658:HIV Infections / Q000453:epidemiology* / Q000276:immunology / Q000821:virology*; D015497:HIV-1 / Q000145:classification; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D016012:Poisson Distribution; D012307:Risk Factors; D012959:Socioeconomic Factors; D013636:Tanzania / Q000453:epidemiology; D019562:Viral Load; D014766:Viremia / Q000453:epidemiology / Q000276:immunology / Q000821:virology; D055815:Young Adult