Natural control of HIV infection in young women in South Africa: HPTN 068

Mariya V. Sivay, Jessica M. Fogel, Jing Wang, Yinfeng Zhang, Estelle Piwowar-Manning, William Clarke, Autumn Breaud, Joel Blankson, Erica L. Hamilton, Kathleen Kahn, Amanda Selin, F. Xavier Gomez-Olive, Catherine Macphail, James P. Hughes, Audrey Pettifor, Susan H. Eshleman

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Some individuals control HIV replication without antiretroviral (ARV) therapy. Objective: To analyze viral suppression in young women in rural South Africa enrolled in a trial evaluating a behavioral intervention for HIV prevention. Methods: Plasma samples were obtained from women ages 13–24 (81 infected at enrollment, 164 seroconverters). ARV testing was performed using an assay that detects 20 ARV drugs. Women were classified as viremic controllers if they were virally suppressed for ≥12 months with no ARV drug use. Results: Samples from 216/245 (88.2%) women had no ARV drugs detected at their first HIV-positive visit. Thirty-four (15.7%) of the 216 women had a viral load <2,000 copies/mL. Fifteen of the 34 women were followed for ≥12 months; 12 were virally suppressed with no ARV drugs detected during follow-up. These women were classified as viremic controllers (overall: 12/216=5.6%). The median CD4 cell count at the first HIV-positive visit was higher among the 12 controllers than among the 204 women who were not using ARV drugs (759 vs. 549 cells/mm 3 , p=0.02). Some women had a viral load <40 copies/mL at a single study visit, but none were classified as elite controllers (viral load <40 copies/mL for ≥12 months with no ARV drug use). Conclusions: In this cohort, 5.6% of women who were not using ARV drugs had sustained viral suppression. This represents a minimum estimate of the frequency of viremic controllers in this cohort, since some women were not followed long enough to meet the criteria for classification.

Original languageEnglish (US)
Pages (from-to)202-208
Number of pages7
JournalHIV Clinical Trials
Volume19
Issue number5
DOIs
StatePublished - 2018

Keywords

  • HIV
  • Natural control
  • South Africa
  • Viremic controllers
  • Young women

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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