title: Dynamics of viremia in primary HIV-1 infection in Africans: insights from analyses of host and viral correlates.
abstract: In HIV-1 infection, plasma viral load (VL) has dual implications for pathogenesis and public health. Based on well-known patterns of HIV-1 evolution and immune escape, we hypothesized that VL is an evolving quantitative trait that depends heavily on duration of infection (DOI), demographic features, human leukocyte antigen (HLA) genotypes and viral characteristics. Prospective data from 421 African seroconverters with at least four eligible visits did show relatively steady VL beyond 3 months of untreated infection, but host and viral factors independently associated with cross-sectional and longitudinal VL often varied by analytical approaches and sliding time windows. Specifically, the effects of age, HLA-B(⁎)53 and infecting HIV-1 subtypes (A1, C and others) on VL were either sporadic or highly sensitive to time windows. These observations were strengthened by the addition of 111 seroconverters with 2-3 eligible VL results, suggesting that DOI should be a critical parameter in epidemiological and clinical studies.
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Heather A
authors.initials: HA
authors.lastname: Prentice
authors.affiliation: International AIDS Vaccine Initiative, New York City, NY, USA; Department of Epidemiology & Biostatistics, UCSF, San Francisco, CA, USA.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Price
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Travis R
authors.initials: TR
authors.lastname: Porter
authors.affiliation: International AIDS Vaccine Initiative, Human Immunology Laboratory, Chelsea and Westminster Hospital, London, UK.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Cormier
authors.affiliation: Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mugavero
authors.affiliation: MRC/UVRI Uganda Virus Research Unit on AIDS, Masaka Site, Masaka, Uganda.
authors.forename: Anatoli
authors.initials: A
authors.lastname: Kamali
authors.affiliation: Projet San Francisco, Kigali, Rwanda.
authors.forename: Etienne
authors.initials: E
authors.lastname: Karita
authors.affiliation: Zambia-Emory HIV Research Project, Lusaka, Zambia.
authors.forename: Shabir
authors.initials: S
authors.lastname: Lakhi
authors.affiliation: Centre for Geographic Medicine Research, Kenya Medical Research Institute (KEMRI), Kilifi, Kenya; Centre for Clinical Vaccinology and Tropical Medicine, University of Oxford, Headington, UK.
authors.forename: Eduard J
authors.initials: EJ
authors.lastname: Sanders
authors.affiliation: Kenya AIDS Vaccine Initiative (KAVI), Nairobi, Kenya.
authors.forename: Omu
authors.initials: O
authors.lastname: Anzala
authors.affiliation: International AIDS Vaccine Initiative, New York City, NY, USA.
authors.forename: Pauli N
authors.initials: PN
authors.lastname: Amornkul
authors.affiliation: Zambia-Emory HIV Research Project, Lusaka, Zambia; Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Allen
authors.affiliation: Vaccine Research Center, Emory University, Atlanta, GA, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Hunter
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Kaslow
authors.affiliation: International AIDS Vaccine Initiative, Human Immunology Laboratory, Chelsea and Westminster Hospital, London, UK.
authors.forename: Jill
authors.initials: J
authors.lastname: Gilmour
authors.affiliation: Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. Electronic address: jtang@uab.edu.
authors.forename: Jianming
authors.initials: J
authors.lastname: Tang
mesh_terms: D000328:Adult; D000349:Africa / Q000453:epidemiology; D000914:Antibodies, Viral / Q000097:blood; D044383:Black People; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000453:epidemiology / Q000235:genetics / Q000276:immunology / Q000821:virology*; D015497:HIV-1 / Q000235:genetics / Q000502:physiology*; D006680:HLA Antigens / Q000235:genetics / Q000276:immunology; D054884:Host-Pathogen Interactions; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D019562:Viral Load; D014766:Viremia / Q000453:epidemiology / Q000235:genetics / Q000276:immunology / Q000821:virology*
chemical_list: D000914:Antibodies, Viral; D006680:HLA Antigens
keywords: Africa; HIV-1; HLA; Statistical models; Subtype; Viral load