Viral and Host Characteristics of Recent and Established HIV-1 Infections in Kisumu based on a Multiassay Approach

Sci Rep. 2016 Nov 29:6:37964. doi: 10.1038/srep37964.

Abstract

Integrated approaches provide better understanding of HIV/AIDS epidemics. We optimised a multiassay algorithm (MAA) and assessed HIV incidence, correlates of recent infections, viral diversity, plus transmission clusters among participants screened for Kisumu Incidence Cohort Study (KICoS1) (2007-2009). We performed BED-CEIA, Limiting antigen (LAg) avidity, Biorad avidity, and viral load (VL) tests on HIV-positive samples. Genotypic analyses focused on HIV-1 pol gene. Correlates of testing recent by MAA were assessed using logistic regression model. Overall, 133 (12%, 95% CI: 10.2-14.1) participants were HIV-positive, of whom 11 tested recent by MAA (BED-CEIA OD-n < 0.8 + LAg avidity OD-n < 1.5 + VL > 1000 copies/mL), giving an incidence of 1.46% (95% CI: 0.58-2.35) per year. This MAA-based incidence was similar to longitudinal KICoS1 incidence. Correlates of testing recent included sexually transmitted infection (STI) treatment history (OR = 3.94, 95% CI: 1.03-15.07) and syphilis seropositivity (OR = 10.15, 95% CI: 1.51-68.22). Overall, HIV-1 subtype A (63%), D (15%), C (3%), G (1%) and recombinants (18%), two monophyletic dyads and intrinsic viral mutations (V81I, V81I/V, V108I/V and K101Q) were observed. Viral diversity mirrored known patterns in this region, while resistance mutations reflected likely non-exposure to antiretroviral drugs. Management of STIs may help address ongoing HIV transmission in this region.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Algorithms
  • Female
  • HIV Antibodies / blood*
  • HIV Infections / diagnosis*
  • HIV Infections / epidemiology
  • HIV Infections / virology
  • HIV Seropositivity / diagnosis*
  • HIV Seropositivity / epidemiology
  • HIV Seropositivity / virology
  • HIV-1 / pathogenicity*
  • Humans
  • Kenya / epidemiology
  • Longitudinal Studies
  • Male
  • Prospective Studies
  • Serologic Tests*
  • Young Adult

Substances

  • HIV Antibodies

Grants and funding