Viruslast und viral load setpoint bei HIV-1-positiven Erwachsenen aus Mbeya Region, Tansania

Background: The viral load setpoint (VLS) is an important predictor
of HIV disease progression, but there is a lack of information
regarding the VLS and its possible determinants in African
populations. Methods: Initially HIV-negative adults from 3 distinct
groups(female bar workers, females, and males from the general
population) were followed for up to 4 years. The VLS was calculated
for 108 seroconverters and associations of the VLS with possible
risk factors were analyzed using univariate and multivariate
regression. Results: The median VLS for female bar workers,
females, and males from the general population were 69,850, 28,600,
and 158,000 RNA copies per milliliter, respectively. Significant
associations with an elevated viral load were observed for male
gender [risk ratio (RR) = 1.83, 95% confidence interval (95% CI) =
1.14 to 2.93], the expression of harmful HLA I alleles (RR = 1.73,
95% CI = 1.13 to 2.66) and multiple infection with different HIV-1
subtypes (RR = 1.65, 95% CI = 1.03 to 2.66). Bar workers were
considerably more often infected with different HIV-1 subtypes than
participants from the general population. Conclusions: Our study
confirms that gender and the expression of different HLA class I
alleles are important determinants of the viremia at VLS, and it
also corroborates an earlier finding that multiple infection with
different HIV-1 subtypes is associated with a higher VLS.