Viral Load and CD4 Count Dynamics After HIV-1 Seroconversion in Homosexual and Bisexual Men in Rio de Janeiro, Brazil

PURPOSE:Reliable predictors of HIV disease progression are scarce in developing countries, where most HIV infections occur. We describe early virologic and immunologic events among men who have sex with men in Rio de Janeiro, Brazil. METHODS:Seroconverters from 2 high-risk cohorts were followed for...

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Bibliographic Details
Published in:	Journal of acquired immune deficiency syndromes (1999) Vol. 43; no. 4; pp. 401 - 404
Main Authors:	Djomand, Gaston, Duerr, Ann, Faulhaber, José Cláudio, Struchiner, Claudio J, Pacheco, A Guilherme, Barroso, Paulo F, Melo, M Fatima, Schechter, Mauro
Format:	Journal Article
Language:	English
Published:	Hagerstown, MD Lippincott Williams & Wilkins, Inc 01-12-2006 Lippincott Williams & Wilkins Lippincott Williams & Wilkins Ovid Technologies
Subjects:	Adult AIDS/HIV Antiretroviral drugs Biological and medical sciences Bisexuality Brazil CD4 Lymphocyte Count Cohort Studies Developing countries Fundamental and applied biological sciences. Psychology Gays & lesbians HIV HIV Infections - immunology HIV Infections - virology HIV Seropositivity - immunology HIV Seropositivity - virology HIV-1 - genetics HIV-1 - isolation & purification HIV-1 - physiology Homosexuality Human immunodeficiency virus Human immunodeficiency virus 1 Human viral diseases Humans Immune system Infectious diseases LDCs Male Medical sciences Microbiology Middle Aged Miscellaneous RNA, Viral - blood Viral diseases Viral Load Virology South America Brazil America Human Homosexuality Microbiology HIV-1 virus Retroviridae Bisexuality Lentivirus men who have sex with men Virology Virus HIV seroconversion high risk Brazil Human immunodeficiency virus Viral load
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Summary:	PURPOSE:Reliable predictors of HIV disease progression are scarce in developing countries, where most HIV infections occur. We describe early virologic and immunologic events among men who have sex with men in Rio de Janeiro, Brazil. METHODS:Seroconverters from 2 high-risk cohorts were followed for up to 36 months with periodic laboratory evaluations, plasma viral load, and CD4 count assessments. Viral load and CD4 count mean trajectories were computed. For the modeled viral loads, mean and median values were 24,480 (4.36 log10) and 19,720 (4.29 log10) copies/mL (range 14,880-58,090), respectively. Median CD4 count was 373 cells/μL (range 260-508). Overall variation on viral loads ranged from 4.3 to 5.2 log10 copies/mL with a visible increase in the viral load starting at approximately 600 days (n = 12) after estimated time of seroconversion. The initial period of HIV infection was characterized by an increase in CD4 count (n = 29) followed by a steep decline starting at approximately 200 days (508 cells, 95% CI425 to 569). A gradual decrease was observed in the median CD4 count thereafter, reaching 281 (95% CI100 to 466) at 1000 days after the estimated date of seroconversion. CONCLUSIONS:Although viral load dynamics resembled those observed in developed countries, CD4 counts seem to decline at a faster rate than in the Multicenter AIDS Cohort Study (MACS) cohort. Clinical and survival data are needed to assess the impact of interventions, such as antiretroviral therapy, on the clinical course of HIV infection in Brazil.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1525-4135 1944-7884
DOI:	10.1097/01.qai.0000243117.21788.90