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

• Published in: The Journal of infectious diseases Vol. 183; no. 1; pp. 23 - 35
• Main Authors: Celum, Connie L., Buchbinder, Susan P., Donnell, Deborah, Douglas, John M., Mayer, Kenneth, Koblin, Beryl, Marmor, Michael, Bozeman, Sam, Grant, Robert M., Flores, Jorge, Sheppard, H. W.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.01.2001; University of Chicago Press
• Subjects: Acute Disease; Adult; AIDS; Anti-HIV Agents - therapeutic use; Antiretroviral Therapy, Highly Active; Antiretrovirals; Biological and medical sciences; Blood plasma; CD4 Lymphocyte Count; Cervix Uteri - virology; Cohort Studies; Demography; Drug Therapy, Combination; Female; Fundamental and applied biological sciences. Psychology; HIV; HIV 1; HIV infections; HIV Infections - blood; HIV Infections - diagnosis; HIV Infections - drug therapy; HIV Infections - virology; HIV Seropositivity - blood; HIV Seropositivity - drug therapy; HIV Seropositivity - virology; HIV-1 - isolation & purification; Homosexuality, Male; Human immunodeficiency virus; Human viral diseases; Humans; Infections; Infectious diseases; Major Articles; Male; Medical sciences; Microbiology; Middle Aged; nucleosides; Prevalence; Reverse Transcriptase Polymerase Chain Reaction; Risk Factors; RNA, Viral - blood; Semen - virology; Sexual Behavior; Sexually transmitted diseases; Sexually Transmitted Diseases - blood; Sexually Transmitted Diseases - epidemiology; Sexually Transmitted Diseases - virology; Symptoms; Time Factors; Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Viral Load; Virology; Viruses; Human; Immunopathology; Enzyme; Semen; Acute; Sex; Retroviridae; AIDS; Vaccine; Lentivirus; Immune deficiency; Infection; Virus; Prevention; Peptidases; Multiple resistance; Viral disease; Hydrolases; Nucleoside; Mutation; Human immunodeficiency virus; Viral load; Protease inhibitor
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/317658

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%, ⩽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 log10 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.