Predictors of intact HIV DNA levels among children in Kenya.
AIDS
; 37(6): 871-876, 2023 05 01.
Article
in En
| MEDLINE
| ID: mdl-36723512
ABSTRACT
OBJECTIVE:
We determined predictors of both intact (estimate of replication-competent) and total (intact and defective) HIV DNA in the reservoir among children with HIV.DESIGN:
HIV DNA in the reservoir was quantified longitudinally in children who initiated antiretroviral therapy (ART) at less than 1âyear of age using a novel cross-subtype intact proviral DNA assay that measures both intact and total proviruses. Quantitative PCR was used to measure pre-ART cytomegalovirus (CMV) viral load. Linear mixed effects models were used to determine predictors of intact and total HIV DNA levels (log 10 copies/million).RESULTS:
Among 65 children, median age at ART initiation was 5âmonths and median follow-up was 5.2âyears; 86% of children had CMV viremia pre-ART. Lower pre-ART CD4 + percentage [adjusted relative risk (aRR) 0.87, 95% confidence intervals (95% CI) 0.79-0.97; P â=â0.009] and higher HIV RNA (aRR 1.21, 95% CI 1.06-1.39; P â=â0.004) predicted higher levels of total HIV DNA during ART. Pre-ART CD4 + percentage (aRR 0.76, 95% CI 0.65-0.89; P < 0.001), CMV viral load (aRR 1.16, 95% CI 1.01-1.34; P â=â0.041), and first-line protease inhibitor-based regimens compared with nonnucleoside reverse transcriptase-based regimens (aRR 1.36, 95% CI 1.04-1.77; P â=â0.025) predicted higher levels of intact HIV DNA.CONCLUSION:
Pre-ART immunosuppression, first-line ART regimen, and CMV viral load may influence establishment and sustainment of intact HIV DNA in the reservoir.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
HIV Infections
/
Cytomegalovirus Infections
/
Anti-HIV Agents
Type of study:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Child
/
Humans
Country/Region as subject:
Africa
Language:
En
Journal:
AIDS
Journal subject:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Year:
2023
Document type:
Article