title: Characterization of acute HIV-1 infection in high-risk Nigerian populations.
abstract: BACKGROUND
  Acute phase of human immunodeficiency virus (HIV) infection (AHI) may account for a significant proportion of HIV-1 transmission. We identified and characterized individuals in Nigeria with AHI.
  
  
  METHODS
  Individuals were tested using a combination of rapid HIV testing in mobile units and laboratory-based specimen pooling for nucleic acid amplification testing. Genome sequences were characterized. A linear segmented regression model was fit to serial viral load (VL) measurements to characterize early VL profiles.
  
  
  RESULTS
  Sixteen AHIs were identified from 28 655 persons screened. Specimens were genotyped: 7 (43.8%) were CRF02_AG, 6 (37.5%) were subtype G, 1 (6.3%) was CRF06_cpx, and 2 (12.5%) were unique recombinant forms. No antiretroviral resistance mutations were detected. The mean duration of high VL burden from peak to nadir was 76 days (95% confidence interval [CI], 58-93 days), and the mean rate of viremic control was -0.66 log(10) VL per month. The mean VL at set-point was 4.5 log(10) copies/mL (95% CI, 3.9-5.1 log(10) copies/mL).
  
  
  CONCLUSIONS
  This study is the first to characterize AHI among Nigerians identified as HIV infected before seroconversion who would be otherwise missed by conventional HIV testing. Infections by HIV subtypes in Nigeria exhibit long periods of high viral burden, which can contribute to increased transmissibility.
authors.affiliation: Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA. mcharurat@ihv.umaryland.edu
authors.forename: Man
authors.initials: M
authors.lastname: Charurat
authors.forename: Abdulsalami
authors.initials: A
authors.lastname: Nasidi
authors.forename: Kevin
authors.initials: K
authors.lastname: Delaney
authors.forename: Ahmed
authors.initials: A
authors.lastname: Saidu
authors.forename: Taelisha
authors.initials: T
authors.lastname: Croxton
authors.forename: Prosanta
authors.initials: P
authors.lastname: Mondal
authors.forename: Gambo Gumel
authors.initials: GG
authors.lastname: Aliyu
authors.forename: Niel
authors.initials: N
authors.lastname: Constantine
authors.forename: Alash'le
authors.initials: A
authors.lastname: Abimiku
authors.forename: Jean K
authors.initials: JK
authors.lastname: Carr
authors.forename: John
authors.initials: J
authors.lastname: Vertefeuille
authors.forename: William
authors.initials: W
authors.lastname: Blattner
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology*; D024882:Drug Resistance, Viral / Q000235:genetics; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000453:epidemiology*; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics; D006801:Humans; D008297:Male; D008969:Molecular Sequence Data; D009549:Nigeria / Q000453:epidemiology; D010802:Phylogeny; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D019562:Viral Load; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral