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Yu B, Wu D, Feng C, Xu P, Reinhardt JD, Yang S. Toward a Prognostic Model for Mortality Risk in Older People Living With HIV: A Prospective Cohort Study From Southwestern China. J Am Med Dir Assoc 2024; 25:243-251. [PMID: 37429452 DOI: 10.1016/j.jamda.2023.05.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/31/2023] [Accepted: 05/31/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVE The existing prognostic models for mortality risk in people living with HIV (PLWH) may not be applicable for older PLWH because the risk factors were confined to biomarkers and clinical variables. We developed and validated a nomogram for the prognosis of all-cause mortality in older PLWH based on comprehensive predictors. DESIGN Prospective cohort study. SETTING AND PARTICIPANTS We included 824 participants aged ≥50 years (mean age, 64.0 ± 7.6 years) from 30 study sites in Sichuan, China, and followed up from Nov 2018 to Mar 2021. METHODS Data on demographics, biomarkers, and clinical indicators were extracted from the registry; mental and social factors were assessed by a survey. Elastic net was used to select predictors. A nomogram was developed based on Cox proportional hazards regression model to visualize the relative effect size (points) of the selected predictors. The prognostic index (PI) was calculated by summing points of all predictors to quantify mortality risk. RESULTS Predictive performance of PI from the nomogram was good, with area under the curve of 0.76 for the training set, and 0.77 for the validation set. Change in CD4 count, virological failure in antiretroviral therapy, and living with comorbidities were robust predictors. Depressive symptoms were an important predictor in men, those aged ≥65 years, and those with time of diagnosis <1 year; low social capital was an additional predictor in people aged <65. Mortality risk increased approximately 10-fold among participants whose PI was in the fourth quartile compared with those in the first quartile (hazard ratio, 9.5; 95% CI, 2.9-31.5). CONCLUSION AND IMPLICATIONS Although biological and clinical factors are crucial predictors, mental and social predictors are essential for specific groups. The developed nomogram is useful for identifying risk factors and groups at risk of mortality in older PLWH.
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Affiliation(s)
- Bin Yu
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China; West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; Sichuan Research Center of Sexual Sociology and Sex Education, Chengdu, China
| | - Dan Wu
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China; Departmemt of Clinical Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Chuanteng Feng
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China; West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Peng Xu
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jan D Reinhardt
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu, China; Jiangsu Province Hospital/Nanjing University First Affiliated Hospital, Nanjing, China; Swiss Paraplegic Research, Nottwil, Switzerland; University of Lucerne, Switzerland.
| | - Shujuan Yang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China; Department of Health Management Center, Clinical Medical College & Affiliated Hospital, Chengdu University, Chengdu, China; International Institute of Spatial Lifecourse Epidemiology (ISLE), Wuhan, China.
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Basoulis D, Pantazis N, Paraskevis D, Iliopoulos P, Papadopoulou M, Akinosoglou K, Hatzakis A, Daikos GL, Psichogiou M. HIV RNA/DNA Levels at Diagnosis Can Predict Immune Reconstitution: A Longitudinal Analysis. Microorganisms 2023; 11:1510. [PMID: 37375012 DOI: 10.3390/microorganisms11061510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 05/27/2023] [Accepted: 06/01/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND HIV DNA mirrors the number of infected cells and the size of the HIV viral reservoir. The aim of this study was to evaluate the effect of pre-cART HIV DNA levels as a predictive marker of immune reconstitution and on the post-cART CD4 counts trends. METHODS HIV DNA was isolated from PBMCs and quantified by real-time PCR. Immune reconstitution was assessed up to four years. Piecewise-linear mixed models were used to describe CD4 count changes. RESULTS 148 people living with HIV (PLWH) were included. The highest rate of immune reconstitution was observed during the first trimester. There was a trend showing that high HIV RNA level resulted in greater increase in CD4 count, especially during the first trimester of cART (difference above vs. below median 15.1 cells/μL/month; 95% CI -1.4-31.5; p = 0.073). Likewise, higher HIV DNA level would predict greater CD4 increases, especially after the first trimester (difference above vs. below median 1.2 cells/μL/month; 95% CI -0.1-2.6; p = 0.071). Higher DNA and RNA levels combined were significantly associated with greater CD4 increase past the first trimester (difference high/high vs. low/low 2.1 cells/μL/month; 95% CI 0.3-4.0; p = 0.024). In multivariable analysis, lower baseline CD4 counts predicted a greater CD4 rise. CONCLUSIONS In successfully treated PLWH, pre-cART HIV DNA and HIV RNA levels are predictors of immune reconstitution.
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Affiliation(s)
- Dimitrios Basoulis
- 1st Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Nikos Pantazis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Dimitrios Paraskevis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Panos Iliopoulos
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Martha Papadopoulou
- 1st Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Karolina Akinosoglou
- Department of Internal Medicine and Infectious Diseases, University General Hospital of Patras, Medical School, University of Patras, 26504 Patras, Greece
| | - Angelos Hatzakis
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - George L Daikos
- 1st Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Mina Psichogiou
- 1st Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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3
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Bottanelli M, Ceccarelli D, Lolatto R, Galli L, Guffanti M, Dell'Acqua R, Ponta G, Mori G, Castagna A, Muccini C. Risk of Cardiovascular Diseases or Mortality in People With Higher Values of HIV-1 DNA. J Acquir Immune Defic Syndr 2023; 93:e6-e8. [PMID: 36989135 DOI: 10.1097/qai.0000000000003192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Affiliation(s)
- Martina Bottanelli
- Vita-Salute San Raffaele University, Milan, Italy
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Daniele Ceccarelli
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Riccardo Lolatto
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Laura Galli
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Monica Guffanti
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Raffaele Dell'Acqua
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giacomo Ponta
- Vita-Salute San Raffaele University, Milan, Italy
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Giovanni Mori
- Vita-Salute San Raffaele University, Milan, Italy
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Antonella Castagna
- Vita-Salute San Raffaele University, Milan, Italy
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Camilla Muccini
- Vita-Salute San Raffaele University, Milan, Italy
- Infectious Diseases Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
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4
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Moh DR, Ntakpé JB, Gabillard D, Yayo-Emieme AA, Badjé A, Kouame GM, d'Aquin TT, Danel C, Anglaret X, Eholié SP. Association of cellular HIV-1 DNA and virological success of antiretroviral treatment in HIV-infected sub-Saharan African adults. BMC Infect Dis 2022; 22:100. [PMID: 35093007 PMCID: PMC8800335 DOI: 10.1186/s12879-022-07082-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 01/21/2022] [Indexed: 11/24/2022] Open
Abstract
Background HIV-1 DNA persists in infected cells, forming viral reservoirs. Pre-antiretroviral treatment (ART) HIV-1 DNA load was reported to predict ART success in European severely immunocompromised patients. The aim of this study was to determine whether HIV-1 DNA levels are associated with virological success in less severely immunocompromised patients who receive early ART in sub-Saharan Africa. Methods The association between pre-ART HIV-1 DNA and the virological response after 30 months on ART was studied in multivariate logistic regression in patients randomised to immediate ART groups in the Temprano trial, which assessed the benefits of early ART in HIV-infected adults in Côte d’Ivoire. HIV-1 DNA was quantified in peripheral blood mononuclear cell (PBMC) using real-time PCR. Results HIV-1 DNA levels were measured in 1013 patients. Their medians [IQR] of pre-ART CD4 count, HIV-1 RNA and HIV-1 DNA levels were 465 [379–578]/mm3, 4.7 [4.0–5.3] log10 copies/ml and 2.9 [2.5–3.2] log10 copies/million PBMC, respectively. Pre-ART HIV-1 DNA was significantly correlated with pre-ART HIV-1 RNA (R = 0.59, p < 0.0001). In multivariate analysis, HIV-1 DNA < 3 log10 copies/million PBMC was significantly associated with virological success at M30 after adjustment for other key variables (ART regimen, IPT, sex, age, WHO clinical stage, CD4 and HIV-1 RNA; aOR 1.57; 95% CI 1.08–2.30; p = 0.02). Conclusion Low HIV-1 DNA was statistically associated with virological success in this population of sub-Saharan African adults who started treatment with a median pre-ART CD4 count at 465/mm3. HIV-1 DNA could become a useful tool for guiding some therapeutic decisions in the test-and-treat era. Trial registration TEMPRANO ANRS 12136 ClinicalTrials.gov, number NCT00495651, date of registration 03/07/2007. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07082-2.
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Affiliation(s)
- Desmorys Raoul Moh
- Unité Pédagogique de Dermatologie et Infectiologie, UFR Sciences Médicales, Abidjan, Côte d'Ivoire. .,Programme PAC-CI, 18 BP 1954, Abidjan 18, Côte d'Ivoire. .,Inserm 1219, Université de Bordeaux, Bordeaux, France.
| | - Jean-Baptiste Ntakpé
- Programme PAC-CI, 18 BP 1954, Abidjan 18, Côte d'Ivoire.,Inserm 1219, Université de Bordeaux, Bordeaux, France
| | - Delphine Gabillard
- Programme PAC-CI, 18 BP 1954, Abidjan 18, Côte d'Ivoire.,Inserm 1219, Université de Bordeaux, Bordeaux, France
| | - Arlette Ahoubet Yayo-Emieme
- Programme PAC-CI, 18 BP 1954, Abidjan 18, Côte d'Ivoire.,Centre de Diagnostic et de Recherches sur le SIDA (CeDReS), CHU de Treichville, Abidjan, Côte d'Ivoire
| | - Anani Badjé
- Programme PAC-CI, 18 BP 1954, Abidjan 18, Côte d'Ivoire.,Inserm 1219, Université de Bordeaux, Bordeaux, France
| | - Gérard M Kouame
- Programme PAC-CI, 18 BP 1954, Abidjan 18, Côte d'Ivoire.,Inserm 1219, Université de Bordeaux, Bordeaux, France
| | - Toni Thomas d'Aquin
- Centre de Diagnostic et de Recherches sur le SIDA (CeDReS), CHU de Treichville, Abidjan, Côte d'Ivoire
| | - Christine Danel
- Programme PAC-CI, 18 BP 1954, Abidjan 18, Côte d'Ivoire.,Inserm 1219, Université de Bordeaux, Bordeaux, France
| | - Xavier Anglaret
- Programme PAC-CI, 18 BP 1954, Abidjan 18, Côte d'Ivoire.,Inserm 1219, Université de Bordeaux, Bordeaux, France
| | - Serge P Eholié
- Unité Pédagogique de Dermatologie et Infectiologie, UFR Sciences Médicales, Abidjan, Côte d'Ivoire.,Programme PAC-CI, 18 BP 1954, Abidjan 18, Côte d'Ivoire.,Inserm 1219, Université de Bordeaux, Bordeaux, France
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5
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Affi R, Gabillard D, Kouame GM, Ntakpe JB, Moh R, Badje A, Danel C, Inwoley A, Eholié SP, Anglaret X, Weiss L. Plasma sVCAM-1, antiretroviral therapy and mortality in HIV-1-infected West African adults. HIV Med 2022; 23:717-726. [PMID: 35023284 DOI: 10.1111/hiv.13230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 12/06/2021] [Accepted: 12/23/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES We report the association between pre-antiretroviral therapy (pre-ART) soluble vascular cell adhesion molecule-1 (sVCAM-1) levels and long-term mortality in HIV-infected West African adults participating in a trial of early ART in West Africa (Temprano ANRS 12136 trial). METHODS The ART-naïve HIV-infected adults were randomly assigned to start ART immediately or defer ART until the WHO criteria were met. Participants who completed the trial follow-up were invited to participate in a post-trial phase (PTP). The PTP end-point was all-cause death. We used multivariable Cox proportional models to analyse the association between baseline sVCAM-1 and all-cause death, adjusting for ART strategy, sex, CD4 count, plasma HIV-1 RNA and peripheral blood mononuclear cell HIV-1 DNA levels. RESULTS In all, 954 adults (77% women, median CD4 count of 387 cells/μL) were randomly assigned to start ART immediately (n = 477) or to defer initiation of ART (n = 477). They were followed for a median of 5.8 years [interquartile range (IQR): 5.2-6.3]. In multivariable analysis, the risk of death was significantly associated with baseline sVCAM-1 [≥1458 vs. < 1458 ng/mL; adjusted hazard ratio = 2.86, 95% confidence interval (CI): 1.60-5.11]. The 6-year probability of death rates were 14.4% (95%CI: 9.1-22.6) and 9.4% (5.4-16.1) in patients with baseline sVCAM-1 ≥ 1458 ng/mL randomized to deferred and immediate ART, respectively, and 3.8% (2.2-6.5) and 3.5% (1.9-6.3) in patients with baseline sVCAM-1 < 1458 ng/mL randomized to deferred and immediate ART. The median difference between pre-ART and 12-month sVCAM-1 levels in patients randomized to immediate ART was -252 (IQR: -587 to -61). CONCLUSIONS Pre-ART sVCAM-1 levels were significantly associated with mortality, independently of whether ART was started immediately or deferred, but they significantly decreased after 12 months of ART.
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Affiliation(s)
- Roseline Affi
- CeDReS, CHU de Treichville, Abidjan, Côte d'Ivoire.,PACCI/ANRS Research site in Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Université Felix Houphouët Boigny, Abidjan, Côte d'Ivoire
| | - Delphine Gabillard
- PACCI/ANRS Research site in Côte d'Ivoire, Abidjan, Côte d'Ivoire.,INSERM U1219, University of Bordeaux, IRD, Bordeaux, France
| | - Gérard Menan Kouame
- PACCI/ANRS Research site in Côte d'Ivoire, Abidjan, Côte d'Ivoire.,INSERM U1219, University of Bordeaux, IRD, Bordeaux, France
| | - Jean Baptiste Ntakpe
- PACCI/ANRS Research site in Côte d'Ivoire, Abidjan, Côte d'Ivoire.,INSERM U1219, University of Bordeaux, IRD, Bordeaux, France
| | - Raoul Moh
- PACCI/ANRS Research site in Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Université Felix Houphouët Boigny, Abidjan, Côte d'Ivoire
| | - Anani Badje
- PACCI/ANRS Research site in Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Université Felix Houphouët Boigny, Abidjan, Côte d'Ivoire
| | - Christine Danel
- PACCI/ANRS Research site in Côte d'Ivoire, Abidjan, Côte d'Ivoire.,INSERM U1219, University of Bordeaux, IRD, Bordeaux, France
| | - André Inwoley
- CeDReS, CHU de Treichville, Abidjan, Côte d'Ivoire.,PACCI/ANRS Research site in Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Université Felix Houphouët Boigny, Abidjan, Côte d'Ivoire
| | - Serge P Eholié
- PACCI/ANRS Research site in Côte d'Ivoire, Abidjan, Côte d'Ivoire.,Université Felix Houphouët Boigny, Abidjan, Côte d'Ivoire
| | - Xavier Anglaret
- PACCI/ANRS Research site in Côte d'Ivoire, Abidjan, Côte d'Ivoire.,INSERM U1219, University of Bordeaux, IRD, Bordeaux, France
| | - Laurence Weiss
- Université de Paris, Faculté de Santé, UFR de Médecine, Paris, France.,Service d'Immunologie Clinique, Hôpital Hôtel Dieu, AP-HP, Paris, France.,Institut de Recherche Saint Louis, INSERM U976, Paris, France
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6
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N’takpé JB, Gabillard D, Moh R, Gardiennet E, Toni TD, Kouame GM, Badje A, Emieme A, Karcher S, Le Carrou J, Ménan H, Danel C, Eholie SP, Rouzioux C, Anglaret X, Lambotte O. Elite and viremic HIV-1 controllers in West Africa. AIDS 2022; 36:29-38. [PMID: 34524145 PMCID: PMC8654265 DOI: 10.1097/qad.0000000000003072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 07/03/2021] [Accepted: 07/15/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Data on HIV-1 controllers in Africa are scarce. We report the proportion of HIV-1 controllers in a group of adults prospectively monitored with frequent viral load measurements as part of a clinical trial in West Africa. METHODS For the Temprano trial, antiretroviral therapy (ART)-naive HIV-1 infected adults with no criteria for starting ART were randomized to start ART immediately or defer ART until the WHO starting criteria were met. Plasma viral load was measured every 6 months. The trial follow-up was 30 months. We considered all Temprano participants randomized to defer ART. Patients with all semestrial viral <2000 copies/ml and still off ART at month 30 were defined as HIV-1 controllers. Controllers with all viral loads <50 copies/ml were defined as elite controllers, the rest as viremic controllers. RESULTS Of the 1023 HIV-1-infected adults randomized in the Temprano deferred-ART group, 18 (1.8%) met the criteria for classification as HIV controllers, of whom seven (0.7%) were elite controllers and 11 (1.1%) viremic controllers. The HIV-1 controllers had low peripheral blood mononuclear cell HIV-1 DNA and low inflammatory marker levels. They maintained high CD4+ cell count and percentages and had a low morbidity rate. DISCUSSION HIV controllers exist in Africa at a proportion close to that reported elsewhere. They represent a small fraction of all HIV-1-infected patients but raise important questions. Further studies should assess whether starting ART might represent more risk than benefit for some controllers, and where it does, how to identify these patients before they start ART.
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Affiliation(s)
- Jean Baptiste N’takpé
- Inserm 1219, University of Bordeaux, IRD, Bordeaux, France
- PACCI/ANRS Research Center
- Département de Dermatologie et Maladies Infectieuses, Université Felix Houphouët Boigny, Abidjan, Côte d’Ivoire
| | - Delphine Gabillard
- Inserm 1219, University of Bordeaux, IRD, Bordeaux, France
- PACCI/ANRS Research Center
| | - Raoul Moh
- Inserm 1219, University of Bordeaux, IRD, Bordeaux, France
- PACCI/ANRS Research Center
- Département de Dermatologie et Maladies Infectieuses, Université Felix Houphouët Boigny, Abidjan, Côte d’Ivoire
| | - Elise Gardiennet
- AP-HP, CHU Necker Enfants Malades, Université Paris Descartes, Paris, France
| | - Thomas-d’Aquin Toni
- Inserm 1219, University of Bordeaux, IRD, Bordeaux, France
- PACCI/ANRS Research Center
- CeDReS, CHU de Treichville, Abidjan, Côte d’Ivoire
| | - Gérard M. Kouame
- Inserm 1219, University of Bordeaux, IRD, Bordeaux, France
- PACCI/ANRS Research Center
- Département de Dermatologie et Maladies Infectieuses, Université Felix Houphouët Boigny, Abidjan, Côte d’Ivoire
| | - Anani Badje
- Inserm 1219, University of Bordeaux, IRD, Bordeaux, France
- PACCI/ANRS Research Center
- Département de Dermatologie et Maladies Infectieuses, Université Felix Houphouët Boigny, Abidjan, Côte d’Ivoire
| | - Arlette Emieme
- Inserm 1219, University of Bordeaux, IRD, Bordeaux, France
- PACCI/ANRS Research Center
- CeDReS, CHU de Treichville, Abidjan, Côte d’Ivoire
| | - Sophie Karcher
- Inserm 1219, University of Bordeaux, IRD, Bordeaux, France
- PACCI/ANRS Research Center
| | - Jérome Le Carrou
- Inserm 1219, University of Bordeaux, IRD, Bordeaux, France
- PACCI/ANRS Research Center
| | - Hervé Ménan
- Inserm 1219, University of Bordeaux, IRD, Bordeaux, France
- PACCI/ANRS Research Center
- CeDReS, CHU de Treichville, Abidjan, Côte d’Ivoire
| | - Christine Danel
- Inserm 1219, University of Bordeaux, IRD, Bordeaux, France
- PACCI/ANRS Research Center
| | - Serge P. Eholie
- Inserm 1219, University of Bordeaux, IRD, Bordeaux, France
- PACCI/ANRS Research Center
- Département de Dermatologie et Maladies Infectieuses, Université Felix Houphouët Boigny, Abidjan, Côte d’Ivoire
| | - Christine Rouzioux
- PACCI/ANRS Research Center
- Faculté de Médecine, Université Paris Descartes, Paris
| | - Xavier Anglaret
- Inserm 1219, University of Bordeaux, IRD, Bordeaux, France
- PACCI/ANRS Research Center
| | - Olivier Lambotte
- AP-HP Paris Saclay, Hôpital Bicêtre, Clinical Immunology Department
- Université Paris-Saclay, Inserm, CEA, Center for Immunology of Viral, Auto-immune, Hematological and Bacterial diseases (IDMIT/IMVA-HB), Le Kremlin Bicêtre, France
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7
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Quantification of Total HIV DNA as a Marker to Measure Viral Reservoir: Methods and Potential Implications for Clinical Practice. Diagnostics (Basel) 2021; 12:diagnostics12010039. [PMID: 35054206 PMCID: PMC8774405 DOI: 10.3390/diagnostics12010039] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 12/19/2021] [Accepted: 12/21/2021] [Indexed: 01/08/2023] Open
Abstract
The focus of this review is to examine the importance of quantifying total HIV DNA to target the HIV reservoir and the clinical implications and challenges involved in its future application in clinical practice. Despite intrinsic limitations, the quantification of total HIV DNA is currently the most widely used marker for exploring the HIV reservoir. As it allows estimating all forms of HIV DNA in the infected cells, total HIV DNA load is the biomarker of the HIV reservoir that provides most of the insights into HIV pathogenesis. The clinical role of total HIV-DNA in both untreated and treated patients is extensively supported by important lines of evidence. Thus, predictive models that include total HIV DNA load together with other variables could constitute a prognostic tool for use in clinical practice. To date, however, this marker has been primarily used in experimental evaluations. The main challenge is technical. Although the implementation of droplet digital PCR could improve analytical performance over real-time PCR, the lack of standardization has made cross-comparisons of the data difficult. An effort by investigators to compare protocols is needed. Furthermore, the main effort now should be to involve the biomedical industry in the development of certified assays for in vitro diagnostics use.
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