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Antibody Maturation and Viral Diversification in HIV-Infected Women.doc

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Antibody Maturation and Viral Diversification in HIV-Infected Women

AntibodyMaturationandViralDiversificationinHIV- InfectedWomen MariaM.James1,OliverLaeyendecker2,3,JinSun4,DonaldR.Hoover5,CarolineE.Mullis3, MatthewM.Cousins1,ThomasCoates6,RichardD.Moore3,GaborD.Kelen7,MaryGlennFowler1, JohnstoneJ.Kumwenda8,LynneM.Mofenson9,NewtonI.Kumwenda4,TahaE.Taha4, SusanH.Eshleman1* 1DepartmentofPathology,JohnsHopkinsUniv.SchoolofMedicine,Baltimore,Maryland,UnitedStatesofAmerica,2LaboratoryofImmunoregulation,NationalInstitute ofAllergyandInfectiousDiseases,NationalInstitutesofHealth,Bethesda,Maryland,UnitedStatesofAmerica,3Dept.ofMedicine,JohnsHopkinsUniversitySchoolof Medicine,Baltimore, Maryland,United States ofAmerica,4Dept. ofEpidemiology,Johns HopkinsUniversityBloombergSchoolofPublicHealth,Baltimore, Maryland, UnitedStatesofAmerica,5DepartmentofStatisticsandBiostatisticsandInstituteforHealth,HealthCarePolicyandAgingResearch,RutgersUniversity,Piscataway,New Jersey,UnitedStatesofAmerica,6PrograminGlobalHealth,UniversityofCaliforniaLosAngeles,LosAngeles,California,UnitedStatesofAmerica,7Dept.ofEmergency Medicine,JohnsHopkinsUniv.SchoolofMedicine,Baltimore,Maryland,UnitedStatesofAmerica,8Dept.ofMedicine,CollegeofMedicine,UniversityofMalawi,Blantyre, Malawi,9Pediatric, Adolescent, andMaternalAIDSBranch,EuniceKennedy ShriverNationalInstitute ofChildHealthandHumanDevelopment,NationalInstitutes of Health,Rockville,Maryland,UnitedStatesofAmerica Abstract Introduction: The Post-exposure Prophylaxis in Infants (PEPI)-Malawi trial evaluated infant antiretroviral regimens for preventionofpost-natalHIVtransmission.Amulti-assayalgorithm(MAA)thatincludestheBEDcaptureimmunoassay,an avidityassay,CD4cellcount,andviralloadwasusedtoidentifywomenwhowerevs.werenotrecentlyinfectedatthetime ofenrollment(MAArecent,N=73;MAAnon-recent,N=2,488);asubsetofthewomenintheMAAnon-recentgroupknown tohavebeenHIVinfectedforatleast2yearsbeforeenrollment(knownnon-recent,N=54).Antibodymaturationandviral diversificationwereexaminedinthesewomen. Methods: Samples col