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13th International AIDS ConferenceDurban, South Africa - July 9-July 14, 2000 |
Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. TuOrC368)
Learmont J, Birch M-R, Deacon N, Sullivan J
J. Learmont, Australian Red Cross Blood Service-NSW, 3/131 Clarence st, Sydney 2000, NSW, Australia, Tel.: +61 2 9229 43 00, Fax: +61 2 9229 44 79, E-mail: jlearmont@arcbs.redcross.org.au
BACKGROUND: The SBBC were infected between 1981 and 1984 with a strain HIV-1 that has a deletion in the nef/LTR region. We here examine the different responses to infection between members of the SBBC that have emerged after long term infection.
METHODS: Analysis of HIV progression markers in members of the SBBC to 31 January 2000.
RESULTS: Three members of the cohort with stable and normal CD4 counts remain well, and three have slowly declining CD4 counts with one developing an HIV related condition. Age, gender, length of infection, amount of blood transfused, HLA alleles or chemokine receptors do not account for the different rates of progression observed. Viral load does. The three well recipients have below detection viral load. The donor and two other recipients in whom immunological damage has occurred all have detectable viral load. The donor after 18 years of infection became symptomatic with a CD4 count of 160 (p>0.001), viral load in plasma and cerebral spinal fluid of 9000 and 750,000 copies per m/l respectively. He commenced anti-tuberculosis and antiviral therapy in early 1999. A year later, viral loads were below detection and CD4 count was 390. The two recipients with CD4 counts declining by 30 to 73 cells per cubic m/l per year (p>0.001) remain well. However, one recently commenced antiviral therapy when his CD4 count was 403, viral load in plasma and cerebral spinal 1200, and 900 respectively. Viral loads are now below detection and CD4 count 580. This recipient and the donor have changes in the nef/LTR sequences over the past five years with the most recent-evolved species having larger deletions from this region.
CONCLUSION: Below detection viral load is the only factor identified that explains the longterm non- progression in three SBBC members. Immunological damage has occurred in the other three members with detectable viral load, and the two on therapy have HIV-1 strains evolving into fitter viral strains.
Copyright © 2000 - International AIDS Society (IAS). Reproduction of this abstract (other than one copy for personal reference) must be cleared through the IAS.
