Viral and host factors associated with the HIV-1 viral load setpoint in adults from Mbeya Region, Tanzania.
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.
Saathoff
Elmar
E
Department of Infectious Diseases and Tropical Medicine, Ludwig-Maximilians-University of Munich (LMU), Munich, Germany. elmarsaathoff@web.de
Pritsch
Michael
M
Geldmacher
Christof
C
Hoffmann
Oliver
O
Koehler
Rebecca N
RN
Maboko
Leonard
L
Maganga
Lucas
L
Geis
Steffen
S
McCutchan
Francine E
FE
Kijak
Gustavo H
GH
Kim
Jerome H
JH
Arroyo
Miguel A
MA
Gerhardt
Martina
M
Tovanabutra
Sodsai
S
Robb
Merlin L
ML
Williamson
Carolyn
C
Michael
Nelson L
NL
Hoelscher
Michael
M
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