尼日利亚高危人群中急性 HIV-1 感染的特征。
Characterization of acute HIV-1 infection in high-risk Nigerian populations.
机构信息
Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.
出版信息
J Infect Dis. 2012 Apr 15;205(8):1239-47. doi: 10.1093/infdis/jis103. Epub 2012 Feb 21.
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.
背景
人类免疫缺陷病毒（HIV）感染的急性期（AHI）可能占 HIV-1 传播的很大比例。我们鉴定并描述了尼日利亚的 AHI 患者。
方法
使用移动单位的快速 HIV 检测和基于实验室的标本混合核酸扩增检测对个体进行检测。对基因组序列进行了特征描述。采用线性分段回归模型拟合连续病毒载量（VL）测量值，以描述早期 VL 特征。
结果
从 28655 名筛查者中发现了 16 例 AHI。对标本进行了基因分型：7 例（43.8%）为 CRF02_AG，6 例（37.5%）为亚型 G，1 例（6.3%）为 CRF06_cpx，2 例（12.5%）为独特重组形式。未检测到抗逆转录病毒耐药性突变。从峰值到最低点高 VL 负担的平均持续时间为 76 天（95%置信区间[CI]，58-93 天），病毒血症控制的平均速率为每月-0.66 log（10）VL。固定点的平均 VL 为 4.5 log（10）拷贝/mL（95%CI，3.9-5.1 log（10）拷贝/mL）。
结论
这项研究是首次描述了尼日利亚在常规 HIV 检测之前发现的 HIV 感染者的 AHI。尼日利亚的 HIV 感染亚型具有较长的高病毒载量期，这可能导致传染性增加。
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