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Cross-sectional detection of acute HIV infection: timing of transmission, inflammation and antiretroviral therapy.

ABSTRACT: Acute HIV infection (AHI) is a critical phase of infection when irreparable damage to the immune system occurs and subjects are very infectious. We studied subjects with AHI prospectively to develop better treatment and public health interventions.Cross-sectional screening was employed to detect HIV RNA positive, antibody negative subjects. Date of HIV acquisition was estimated from clinical history and correlated with sequence diversity assessed by single genome amplification (SGA). Twenty-two cytokines/chemokines were measured from enrollment through week 24.Thirty-seven AHI subjects were studied. In 7 participants with limited exposure windows, the median exposure to HIV occurred 14 days before symptom onset. Lack of viral sequence diversification confirmed the short duration of infection. Transmission dates estimated by SGA/sequencing using molecular clock models correlated with transmission dates estimated by symptom onset in individuals infected with single HIV variants (mean of 28 versus 33 days). Only 10 of 22 cytokines/chemokines were significantly elevated among AHI participants at enrollment compared to uninfected controls, and only 4 participants remained seronegative at enrollment.The results emphasize the difficulty in recruiting subjects early in AHI. Viral sequence diversity proved accurate in estimating time of infection. Regardless of aggressive screening, peak viremia and inflammation occurred before enrollment and potential intervention. Given the personal and public health importance, improved AHI detection is urgently needed.

SUBMITTER: Gay C

PROVIDER: S-EPMC3091862 | biostudies-literature | 2011 May

REPOSITORIES: biostudies-literature

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Cross-sectional detection of acute HIV infection: timing of transmission, inflammation and antiretroviral therapy.

Gay Cynthia C Dibben Oliver O Anderson Jeffrey A JA Stacey Andrea A Mayo Ashley J AJ Norris Philip J PJ Kuruc JoAnn D JD Salazar-Gonzalez Jesus F JF Li Hui H Keele Brandon F BF Hicks Charles C Margolis David D Ferrari Guido G Haynes Barton B Swanstrom Ronald R Shaw George M GM Hahn Beatrice H BH Eron Joseph J JJ Borrow Persephone P Cohen Myron S MS

PloS one 20110510 5

<h4>Background</h4>Acute HIV infection (AHI) is a critical phase of infection when irreparable damage to the immune system occurs and subjects are very infectious. We studied subjects with AHI prospectively to develop better treatment and public health interventions.<h4>Methods</h4>Cross-sectional screening was employed to detect HIV RNA positive, antibody negative subjects. Date of HIV acquisition was estimated from clinical history and correlated with sequence diversity assessed by single geno ...[more]

PMID: 21573003

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Dataset Information

Cross-sectional detection of acute HIV infection: timing of transmission, inflammation and antiretroviral therapy.

Publications

Cross-sectional detection of acute HIV infection: timing of transmission, inflammation and antiretroviral therapy.

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