Natural Control of HIV Infection in Young Women in South Africa: HPTN 068

Citation

Sivay, Mariya V.; Fogel, Jessica M.; Wang, Jing; Zhang, Yinfeng; Piwowar-Manning, Estelle; Clarke, William; Breaud, Autumn; Blankson, Joel; Hamilton, Erica L.; & Kahn, Kathleen, et al. (2018). Natural Control of HIV Infection in Young Women in South Africa: HPTN 068. HIV Clinical Trials, 19(5), 202-208. PMCID: PMC6442735

Abstract

BACKGROUND: Some individuals control HIV replication without antiretroviral (ARV) therapy.
OBJECTIVE: To analyze viral suppression in young women in rural South Africa enrolled in a trial evaluating a behavioral intervention for HIV prevention.
METHODS: Plasma samples were obtained from women ages 13-24 (81 infected at enrollment, 164 seroconverters). ARV testing was performed using an assay that detects 20 ARV drugs. Women were classified as viremic controllers if they were virally suppressed for >/=12 months with no ARV drug use.
RESULTS: Samples from 216/245 (88.2%) women had no ARV drugs detected at their first HIV-positive visit. Thirty-four (15.7%) of the 216 women had a viral load <2,000 copies/mL. Fifteen of the 34 women were followed for >/=12 months; 12 were virally suppressed with no ARV drugs detected during follow-up. These women were classified as viremic controllers (overall: 12/216 = 5.6%). The median CD4 cell count at the first HIV-positive visit was higher among the 12 controllers than among the 204 women who were not using ARV drugs (759 vs. 549 cells/mm(3), p = 0.02). Some women had a viral load <40 copies/mL at a single study visit, but none were classified as elite controllers (viral load <40 copies/mL for >/=12 months with no ARV drug use).
CONCLUSIONS: In this cohort, 5.6% of women who were not using ARV drugs had sustained viral suppression. This represents a minimum estimate of the frequency of viremic controllers in this cohort, since some women were not followed long enough to meet the criteria for classification.

URL

http://dx.doi.org/10.1080/15284336.2018.1531534

Reference Type

Journal Article

Year Published

2018

Journal Title

HIV Clinical Trials

Author(s)

Sivay, Mariya V.
Fogel, Jessica M.
Wang, Jing
Zhang, Yinfeng
Piwowar-Manning, Estelle
Clarke, William
Breaud, Autumn
Blankson, Joel
Hamilton, Erica L.
Kahn, Kathleen
Selin, Amanda M.
Gómez-Olivé, F. Xavier
MacPhail, Catherine Lorne
Hughes, James P.
Pettifor, Audrey E.
Eshleman, Susan H.

PMCID

PMC6442735

ORCiD

Pettifor - 0000-0002-3387-0817