Recent HIV-1 Infection Identification of Individuals with High Viral Load Setpoint in a Voluntary Counselling and Testing Centre in Rural Mozambique 英文参考文献.docVIP

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Recent HIV-1 Infection Identification of Individuals with High Viral Load Setpoint in a Voluntary Counselling and Testing Centre in Rural Mozambique 英文参考文献.doc

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Recent HIV-1 Infection Identification of Individuals with High Viral Load Setpoint in a Voluntary Counselling and Testing Centre in Rural Mozambique 英文参考文献

RecentHIV-1Infection:IdentificationofIndividualswith HighViralLoadSetpointinaVoluntaryCounsellingand TestingCentreinRuralMozambique CeliaSerna-Bolea1*,NilsadeDeus2,3,SozinhoAca′cio2,JoseMun?oz1,DelinoNhalungo2,EmilioLetang1, PedroAlonso1,2,DeniseNaniche1* 1Barcelona Centre for International Health Research (CRESIB, Hospital Cl?′nic-Universtitat de Barcelona), Barcelona, Spain, 2Manhic?a Health Research Centre (CISM), Manhic?a, Mozambique,3NationalInstituteofHealth,Maputo,Mozambique Abstract Background:IdentificationofrecentHIV-infectionsisimportantfordescribingtheHIVepidemicandcompilingHIV-RNA- setpoint data for future HIV intervention trials. We conducted a study to characterize recent infections, and HIV-RNA- setpoint within the adult population presenting at a voluntary counselling and testing centre (VCT) in southern Mozambique. Methods:AlladultsattendingtheManhic?aDistrict-HospitalVCTbetweenAprilandOctober2009wererecruitediftheyhad atleastonepositiverapidHIV-serologytest.PatientswerescreenedforrecentHIV-1infectionbyBED-CEIAHIV-incidence test.Clinicalexamination,assessmentofHIV-RNAandCD4cellcountswereperformedatenrollment,4and10months. Results:Ofthe492participantsincludedinthisstudy,theprevalenceofrecentinfectionsasdefinedbyBED-CEIAtest,CD4 counts.200cells/mlandHIV-RNA.400copies/mL,was11.58%(57/492;95%CI8.89–14.74).DuetoheterogeneityinHIV- RNAlevelsinrecentlyinfectedpatients,individualswerecategorizedashaving‘‘high’’HIV-RNAloadiftheirHIV-RNAlevel wasabovethemedian(4.98log10copies/mL)atdiagnosis.The‘‘high’’HIV-RNAgroupsustainedasignificantlyhigherHIV- viralloadatallvisitswithamedianHIV-RNAsetpointof5.22log10copies/mL(IQR5.18–5.47)ascomparedtothemedianof 4.15log10copies/ml(IQR3.37–4.43)fortheotherpatients(p=0.0001). Conclusion: The low proportion of recent HIV-infections among HIV-seropositive VCT clients suggests that most of this populationattendstheVCTatlaterstagesofHIV/AIDS.CharacterizationofHIV-RNA-setpointmayservetoidentifyrecently infectedindividualsmaint