Lucarelli Aude, Rabier Sébastien, Vergeade Fanja, Guedj Myriam El, Vaz Tania, Cisse Hawa, Epelboin Loïc, Abboud Philippe, Turnier Paul Le, Djossou Félix, Michaud Céline, Delin Claudia, Divino Flavia, Verin Karine, Bienvenu Ketty, Adenis Antoine, Nacher Mathieu
COREVIH Guyane, Centre hospitalier de Cayenne, Cayenne, French Guiana.
Département de Santé Publique, Centre Hospitalier de l'Ouest Guyanais, Saint Laurent du Maroni, French Guiana.
IJID Reg. 2024 Nov 10;13:100487. doi: 10.1016/j.ijregi.2024.100487. eCollection 2024 Dec.
HIV viral load set points may vary between virus subtypes and host characteristics. The HIV epidemic in French Guiana entails a mix of viruses and populations of cosmopolitan origins. In this epidemiological context, we aimed to determine whether, at the scale of our territory, we could identify differences in HIV-1 viral load setpoints in our hospital cohort.
The French Guiana hospital cohort was retrospectively analyzed between 1992 and 2023. Bootstrapped (100 replications) quantile (median) regression modeled the initial HIV-1 viral load with age, sex, nationality, and cluster of differentiation (CD) 4 count at diagnosis as independent variables.
After adjusting for period of analysis and CD4 count at diagnosis, bootstrapped quantile regression (median) showed that Haitians (minus 20,088 copies, <0.0001) and Guyanese (minus 14,087, = 0.039) had a significantly lower viral load at HIV diagnosis than French, males had a greater viral load at HIV diagnosis than females (plus 16,430 copies, <0.0001), each additional year of age was associated with more copies (+345 per year, = 0.002). When compared to those with more than 500 CD4 per ml, persons with CD4 counts at diagnosis below 200 per ml had a greater initial viral load (plus 94,932 copies, <0.0001), as did those with 200-350 CD4 per ml (plus 13,088 copies, <0.0001), and those with (350-500 CD4 per ml) (plus 5643 copies, <0.0001). Non-B viruses seemed to have an independently greater viral load at diagnosis than B viruses (plus 58,402, = 0.029).
We show some significant differences in the viral load set point of different groups. For nationalities, we are inclined to attribute this to differences in the frequency of infecting subtypes. This suggests that models of incidence or date of infection based on CD4 decline may be distorted by this situation.
HIV病毒载量设定点可能因病毒亚型和宿主特征而异。法属圭亚那的HIV疫情涉及多种病毒和具有国际背景的人群。在这种流行病学背景下，我们旨在确定在我们的地区范围内，能否在我们的医院队列中识别出HIV-1病毒载量设定点的差异。
对1992年至2023年期间法属圭亚那医院队列进行回顾性分析。采用自抽样法（100次重复）分位数（中位数）回归，将诊断时的年龄、性别、国籍和分化簇（CD）4细胞计数作为自变量，对初始HIV-1病毒载量进行建模。
在对分析期和诊断时的CD4细胞计数进行调整后，自抽样法分位数回归（中位数）显示，海地人（-20,088拷贝，<0.0001）和圭亚那人（-14,087，=0.039）在HIV诊断时的病毒载量显著低于法国人，男性在HIV诊断时的病毒载量高于女性（+16,430拷贝，<0.0001），年龄每增加一岁，病毒载量增加更多（每年+345拷贝，=0.002）。与每毫升CD4细胞数超过500的人相比，诊断时CD4细胞计数低于每毫升200的人初始病毒载量更高（+94,932拷贝，<0.0001），每毫升CD4细胞数为200 - 350的人也是如此（+13,088拷贝，<0.0001），每毫升CD4细胞数为（350 - 500）的人同样如此（+5,643拷贝，<0.0001）。非B型病毒在诊断时的病毒载量似乎比B型病毒更高（+58,402，=0.029）。
我们发现不同组的病毒载量设定点存在一些显著差异。对于不同国籍，我们倾向于将此归因于感染亚型频率的差异。这表明基于CD4细胞计数下降的发病率或感染日期模型可能会因这种情况而失真。
