Detection and treatment of Fiebig stage I HIV-1 infection in young at-risk women in South Africa: a prospective cohort study.
Identifieur interne : 000732 ( PubMed/Curation ); précédent : 000731; suivant : 000733Detection and treatment of Fiebig stage I HIV-1 infection in young at-risk women in South Africa: a prospective cohort study.
Auteurs : Krista L. Dong [États-Unis] ; Amber Moodley [Afrique du Sud] ; Douglas S. Kwon [États-Unis] ; Musie S. Ghebremichael [États-Unis] ; Mary Dong [États-Unis] ; Nasreen Ismail [Afrique du Sud] ; Zaza M. Ndhlovu [Afrique du Sud] ; Jenniffer M. Mabuka [Afrique du Sud] ; Daniel M. Muema [Afrique du Sud] ; Karyn Pretorius [Afrique du Sud] ; Nina Lin [États-Unis] ; Bruce D. Walker [États-Unis] ; Thumbi Ndung'U [Allemagne]Source :
- The lancet. HIV [ 2352-3018 ] ; 2017.
Abstract
HIV incidence among young women in sub-Saharan Africa remains high and their inclusion in vaccine and cure efforts is crucial. We aimed to establish a cohort of young women detected during Fiebig stage I acute HIV infection in whom treatment was initiated immediately after diagnosis to advance research in this high-risk group.
DOI: 10.1016/S2352-3018(17)30146-7
PubMed: 28978417
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<author><name sortKey="Mabuka, Jenniffer M" sort="Mabuka, Jenniffer M" uniqKey="Mabuka J" first="Jenniffer M" last="Mabuka">Jenniffer M. Mabuka</name>
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<author><name sortKey="Muema, Daniel M" sort="Muema, Daniel M" uniqKey="Muema D" first="Daniel M" last="Muema">Daniel M. Muema</name>
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<author><name sortKey="Pretorius, Karyn" sort="Pretorius, Karyn" uniqKey="Pretorius K" first="Karyn" last="Pretorius">Karyn Pretorius</name>
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<wicri:regionArea>HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban</wicri:regionArea>
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<author><name sortKey="Lin, Nina" sort="Lin, Nina" uniqKey="Lin N" first="Nina" last="Lin">Nina Lin</name>
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<country xml:lang="fr">États-Unis</country>
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<author><name sortKey="Ndung U, Thumbi" sort="Ndung U, Thumbi" uniqKey="Ndung U T" first="Thumbi" last="Ndung'U">Thumbi Ndung'U</name>
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<country xml:lang="fr">Allemagne</country>
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<front><div type="abstract" xml:lang="en">HIV incidence among young women in sub-Saharan Africa remains high and their inclusion in vaccine and cure efforts is crucial. We aimed to establish a cohort of young women detected during Fiebig stage I acute HIV infection in whom treatment was initiated immediately after diagnosis to advance research in this high-risk group.</div>
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<DateCreated><Year>2017</Year>
<Month>10</Month>
<Day>05</Day>
</DateCreated>
<DateRevised><Year>2017</Year>
<Month>10</Month>
<Day>05</Day>
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<Month>Sep</Month>
<Day>29</Day>
</PubDate>
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<Title>The lancet. HIV</Title>
<ISOAbbreviation>Lancet HIV</ISOAbbreviation>
</Journal>
<ArticleTitle>Detection and treatment of Fiebig stage I HIV-1 infection in young at-risk women in South Africa: a prospective cohort study.</ArticleTitle>
<ELocationID EIdType="pii" ValidYN="Y">S2352-3018(17)30146-7</ELocationID>
<ELocationID EIdType="doi" ValidYN="Y">10.1016/S2352-3018(17)30146-7</ELocationID>
<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">HIV incidence among young women in sub-Saharan Africa remains high and their inclusion in vaccine and cure efforts is crucial. We aimed to establish a cohort of young women detected during Fiebig stage I acute HIV infection in whom treatment was initiated immediately after diagnosis to advance research in this high-risk group.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">945 women aged 18-23 years in KwaZulu-Natal, South Africa, who were HIV uninfected and sexually active consented to HIV-1 RNA testing twice a week and biological sampling and risk assessment every 3 months during participation in a 48-96 week life-skills and job-readiness programme. We analysed the effect of immediate combination antiretroviral therapy (ART) on viraemia and immune responses, sexual risk behaviour, and the effect of the socioeconomic intervention.</AbstractText>
<AbstractText Label="FINDINGS" NlmCategory="RESULTS">42 women were diagnosed with acute HIV infection between Dec 1, 2012, and June 30, 2016, (incidence 8·2 per 100 person-years, 95% CI 5·9-11·1), of whom 36 (86%) were diagnosed in Fiebig stage I infection with a median initial viral load of 2·97 log10 copies per mL (IQR 2·42-3·85). 23 of these 36 women started ART at a median of 1 day (1-1) after detection, which limited the median peak viral load to 4·22 log10 copies per mL (3·27-4·83) and the CD4 nadir to 685 cells per μL (561-802). ART also suppressed viral load (to <20 copies per mL) within a median of 16 days (12-26) and, in 20 (87%) of 23 women, prevented seroconversion, as shown with western blotting. 385 women completed the 48 week socioeconomic intervention, of whom 231 were followed up for 1 year. 202 (87%) of these 231 women were placed in jobs, returned to school, or started a business.</AbstractText>
<AbstractText Label="INTERPRETATION" NlmCategory="CONCLUSIONS">Frequent HIV screening combined with a socioeconomic intervention facilitated sampling and risk assessment before and after infection. In addition to detection of acute infection and immediate treatment, we established a cohort optimised for prevention and cure research.</AbstractText>
<AbstractText Label="FUNDING" NlmCategory="BACKGROUND">Bill & Melinda Gates Foundation, National Institute of Allergy and Infectious Diseases, International AIDS Vaccine Initiative, Wellcome Trust, Howard Hughes Medical Institute.</AbstractText>
<CopyrightInformation>Copyright © 2017 Elsevier Ltd. All rights reserved.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Dong</LastName>
<ForeName>Krista L</ForeName>
<Initials>KL</Initials>
<AffiliationInfo><Affiliation>Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA; Infectious Disease Division, Massachusetts General Hospital, Boston, MA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Moodley</LastName>
<ForeName>Amber</ForeName>
<Initials>A</Initials>
<AffiliationInfo><Affiliation>HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Kwon</LastName>
<ForeName>Douglas S</ForeName>
<Initials>DS</Initials>
<AffiliationInfo><Affiliation>Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA; Infectious Disease Division, Massachusetts General Hospital, Boston, MA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Ghebremichael</LastName>
<ForeName>Musie S</ForeName>
<Initials>MS</Initials>
<AffiliationInfo><Affiliation>Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Dong</LastName>
<ForeName>Mary</ForeName>
<Initials>M</Initials>
<AffiliationInfo><Affiliation>Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Ismail</LastName>
<ForeName>Nasreen</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Ndhlovu</LastName>
<ForeName>Zaza M</ForeName>
<Initials>ZM</Initials>
<AffiliationInfo><Affiliation>Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA; HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Mabuka</LastName>
<ForeName>Jenniffer M</ForeName>
<Initials>JM</Initials>
<AffiliationInfo><Affiliation>Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA; HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa; Africa Health Research Institute, University of KwaZulu-Natal, Durban, South Africa.</Affiliation>
</AffiliationInfo>
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<Author ValidYN="Y"><LastName>Muema</LastName>
<ForeName>Daniel M</ForeName>
<Initials>DM</Initials>
<AffiliationInfo><Affiliation>HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa; Africa Health Research Institute, University of KwaZulu-Natal, Durban, South Africa.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Pretorius</LastName>
<ForeName>Karyn</ForeName>
<Initials>K</Initials>
<AffiliationInfo><Affiliation>HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Lin</LastName>
<ForeName>Nina</ForeName>
<Initials>N</Initials>
<AffiliationInfo><Affiliation>Infectious Disease Division, Massachusetts General Hospital, Boston, MA, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Walker</LastName>
<ForeName>Bruce D</ForeName>
<Initials>BD</Initials>
<AffiliationInfo><Affiliation>Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA; Infectious Disease Division, Massachusetts General Hospital, Boston, MA, USA; HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa; Institute for Medical Sciences and Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA; Howard Hughes Medical Institute, Chevy Chase, MD, USA.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Ndung'u</LastName>
<ForeName>Thumbi</ForeName>
<Initials>T</Initials>
<AffiliationInfo><Affiliation>Ragon Institute of MGH, MIT and Harvard, Cambridge, MA, USA; HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa; Africa Health Research Institute, University of KwaZulu-Natal, Durban, South Africa; Max Planck Institute for Infection Biology, Berlin, Germany. Electronic address: ndungu@ukzn.ac.za.</Affiliation>
</AffiliationInfo>
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<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2017</Year>
<Month>09</Month>
<Day>29</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>Netherlands</Country>
<MedlineTA>Lancet HIV</MedlineTA>
<NlmUniqueID>101645355</NlmUniqueID>
<ISSNLinking>2352-3018</ISSNLinking>
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<PubmedData><History><PubMedPubDate PubStatus="received"><Year>2017</Year>
<Month>03</Month>
<Day>14</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="revised"><Year>2017</Year>
<Month>06</Month>
<Day>27</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted"><Year>2017</Year>
<Month>07</Month>
<Day>04</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="entrez"><Year>2017</Year>
<Month>10</Month>
<Day>6</Day>
<Hour>6</Hour>
<Minute>0</Minute>
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<PubMedPubDate PubStatus="pubmed"><Year>2017</Year>
<Month>10</Month>
<Day>6</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
<PubMedPubDate PubStatus="medline"><Year>2017</Year>
<Month>10</Month>
<Day>6</Day>
<Hour>6</Hour>
<Minute>0</Minute>
</PubMedPubDate>
</History>
<PublicationStatus>aheadofprint</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">28978417</ArticleId>
<ArticleId IdType="pii">S2352-3018(17)30146-7</ArticleId>
<ArticleId IdType="doi">10.1016/S2352-3018(17)30146-7</ArticleId>
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