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Be A Hero Vaccine Preparedness Study |
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Early human immunodeficiency virus (HIV) infection in the HIV Network for Prevention Trials Vaccine Preparedness Cohort: risk behaviors, symptoms, and early plasma and genital tract virus load.
Source:
J Infect Dis 2001 Jan 1;183(1):23-35
Authors:
Celum CL, Buchbinder SP, Donnell D, Douglas JM Jr, Mayer K, Koblin B, Marmor M,
Bozeman S, Grant RM, Flores J, Sheppard HW.
Publication Info:
University of Washington HIV Prevention Trials Unit, Harborview Medical Center,
Seattle, WA 98104, USA. ccelum@u.washington.edu [Confidentiality cannot be
guaranteed for information provided via e-mail. People visiting websites from public
or work machines may be leaving traces of their visits on those machines.]
Abstract:
Risk behaviors, symptoms, and virologic characteristics were studied among 103 human
immunodeficiency virus (HIV) seroconverters in vaccine preparedness cohorts during
1995-1998. Overall, 83% of subjects were men who had sex with men; most reported
multiple risk episodes and symptoms (84%, > or =1 symptom) during seroconversion.
Acute HIV was diagnosed in only 8 of 50 who sought medical care. Median initial
pretreatment plasma virus load was 25,800 copies/mL (range, undetectable-262,000
copies/mL) a mean of 4 months after seroconversion, and 9.7% had
nucleoside-associated mutations; none had multidrug resistance. Semen virus load was
more variable, 1.3 log(10) lower and modestly correlated (r=.28; 95% confidence
interval, 0.16-0.42) with plasma among untreated men. When the plasma RNA level was
<5000 copies/mL, 32% of untreated men, 13% on nucleoside regimens, and 7% on
protease inhibitor-containing regimens had detectable seminal RNA. Acute HIV was
seldom diagnosed, representing missed opportunities for early treatment and
prevention. Most subjects had several relatively stable virus loads before
initiation of antiretrovirals, indicating feasibility of assessing HIV vaccines on
virus set point in efficacy trials.
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