Viral load levels measured at set-point have risen over the last decade of the HIV epidemic in the Netherlands.
<h4>Background</h4>HIV-1 RNA plasma concentration at viral set-point is associated not only with disease outcome but also with the transmission dynamics of HIV-1. We investigated whether plasma HIV-1 RNA concentration and CD4 cell count at viral set-point have changed over time in the HI...
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Public Library of Science (PLoS)
2009-10-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0007365&type=printable |
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| author | Luuk Gras Suzanne Jurriaans Margreet Bakker Ard van Sighem Daniela Bezemer Christophe Fraser Joep Lange Jan M Prins Ben Berkhout Frank de Wolf ATHENA National Observational Cohort Study |
| author_facet | Luuk Gras Suzanne Jurriaans Margreet Bakker Ard van Sighem Daniela Bezemer Christophe Fraser Joep Lange Jan M Prins Ben Berkhout Frank de Wolf ATHENA National Observational Cohort Study |
| author_sort | Luuk Gras |
| collection | DOAJ |
| description | <h4>Background</h4>HIV-1 RNA plasma concentration at viral set-point is associated not only with disease outcome but also with the transmission dynamics of HIV-1. We investigated whether plasma HIV-1 RNA concentration and CD4 cell count at viral set-point have changed over time in the HIV epidemic in the Netherlands.<h4>Methodology/principal findings</h4>We selected 906 therapy-naïve patients with at least one plasma HIV-1 RNA concentration measured 9 to 27 months after estimated seroconversion. Changes in HIV-1 RNA and CD4 cell count at viral set-point over time were analysed using linear regression models. The ATHENA national observational cohort contributed all patients who seroconverted in or after 1996; the Amsterdam Cohort Studies (ACS) contributed seroconverters before 1996. The mean of the first HIV-1 RNA concentration measured 9-27 months after seroconversion was 4.30 log(10) copies/ml (95% CI 4.17-4.42) for seroconverters from 1984 through 1995 (n = 163); 4.27 (4.16-4.37) for seroconverters 1996-2002 (n = 232), and 4.59 (4.52-4.66) for seroconverters 2003-2007 (n = 511). Compared to patients seroconverting between 2003-2007, the adjusted mean HIV-1 RNA concentration at set-point was 0.28 log(10) copies/ml (95% CI 0.16-0.40; p<0.0001) and 0.26 (0.11-0.41; p = 0.0006) lower for those seroconverting between 1996-2002 and 1984-1995, respectively. Results were robust regardless of type of HIV-1 RNA assay, HIV-1 subtype, and interval between measurement and seroconversion. CD4 cell count at viral set-point declined over calendar time at approximately 5 cells/mm(3)/year.<h4>Conclusion</h4>The HIV-1 RNA plasma concentration at viral set-point has increased over the last decade of the HIV epidemic in the Netherlands. This is accompanied by a decreasing CD4 cell count over the period 1984-2007 and may have implications for both the course of the HIV infection and the epidemic. |
| format | Article |
| id | doaj-art-6b70a71b233e4c4690e39ff2ca8e6582 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2009-10-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS ONE |
| spelling | doaj-art-6b70a71b233e4c4690e39ff2ca8e65822025-08-20T03:07:17ZengPublic Library of Science (PLoS)PLoS ONE1932-62032009-10-01410e736510.1371/journal.pone.0007365Viral load levels measured at set-point have risen over the last decade of the HIV epidemic in the Netherlands.Luuk GrasSuzanne JurriaansMargreet BakkerArd van SighemDaniela BezemerChristophe FraserJoep LangeJan M PrinsBen BerkhoutFrank de WolfATHENA National Observational Cohort Study<h4>Background</h4>HIV-1 RNA plasma concentration at viral set-point is associated not only with disease outcome but also with the transmission dynamics of HIV-1. We investigated whether plasma HIV-1 RNA concentration and CD4 cell count at viral set-point have changed over time in the HIV epidemic in the Netherlands.<h4>Methodology/principal findings</h4>We selected 906 therapy-naïve patients with at least one plasma HIV-1 RNA concentration measured 9 to 27 months after estimated seroconversion. Changes in HIV-1 RNA and CD4 cell count at viral set-point over time were analysed using linear regression models. The ATHENA national observational cohort contributed all patients who seroconverted in or after 1996; the Amsterdam Cohort Studies (ACS) contributed seroconverters before 1996. The mean of the first HIV-1 RNA concentration measured 9-27 months after seroconversion was 4.30 log(10) copies/ml (95% CI 4.17-4.42) for seroconverters from 1984 through 1995 (n = 163); 4.27 (4.16-4.37) for seroconverters 1996-2002 (n = 232), and 4.59 (4.52-4.66) for seroconverters 2003-2007 (n = 511). Compared to patients seroconverting between 2003-2007, the adjusted mean HIV-1 RNA concentration at set-point was 0.28 log(10) copies/ml (95% CI 0.16-0.40; p<0.0001) and 0.26 (0.11-0.41; p = 0.0006) lower for those seroconverting between 1996-2002 and 1984-1995, respectively. Results were robust regardless of type of HIV-1 RNA assay, HIV-1 subtype, and interval between measurement and seroconversion. CD4 cell count at viral set-point declined over calendar time at approximately 5 cells/mm(3)/year.<h4>Conclusion</h4>The HIV-1 RNA plasma concentration at viral set-point has increased over the last decade of the HIV epidemic in the Netherlands. This is accompanied by a decreasing CD4 cell count over the period 1984-2007 and may have implications for both the course of the HIV infection and the epidemic.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0007365&type=printable |
| spellingShingle | Luuk Gras Suzanne Jurriaans Margreet Bakker Ard van Sighem Daniela Bezemer Christophe Fraser Joep Lange Jan M Prins Ben Berkhout Frank de Wolf ATHENA National Observational Cohort Study Viral load levels measured at set-point have risen over the last decade of the HIV epidemic in the Netherlands. PLoS ONE |
| title | Viral load levels measured at set-point have risen over the last decade of the HIV epidemic in the Netherlands. |
| title_full | Viral load levels measured at set-point have risen over the last decade of the HIV epidemic in the Netherlands. |
| title_fullStr | Viral load levels measured at set-point have risen over the last decade of the HIV epidemic in the Netherlands. |
| title_full_unstemmed | Viral load levels measured at set-point have risen over the last decade of the HIV epidemic in the Netherlands. |
| title_short | Viral load levels measured at set-point have risen over the last decade of the HIV epidemic in the Netherlands. |
| title_sort | viral load levels measured at set point have risen over the last decade of the hiv epidemic in the netherlands |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0007365&type=printable |
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