Strong sex bias in elite control of paediatric HIV infection

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Title: Strong sex bias in elite control of paediatric HIV infection
Authors: Vieira, VA
Zuidewind, P
Muenchhoff, M
Roider, J
Millar, J
Clapson, M
Van Zyl, A
Shingadia, D
Adland, E
Athavale, R
Grayson, N
Ansari, MA
Brander, C
Guash, CF
Naver, L
Puthanakit, T
Songtaweesin, WN
Ananworanich, J
Peluso, D
Thome, B
Pinto, J
Jooste, P
Tudor-Williams, G
Cotton, MF
Goulder, P
Item Type: Journal Article
Abstract: Background: Reports of post-treatment control following antiretroviral therapy (ART) have prompted the question of how common immune control of HIV infection is in the absence of ART. In contrast to adult infection, where elite controllers (EC) have been very well characterized and comprise approximately 0.5% of infections, very few data exist to address this question in paediatric infection. Methods: We describe 11 ART-naïve EC from 10 cohorts of HIV-infected children being followed in South Africa, Brazil, Thailand, and Europe, and describe their key clinical features. Results: All but one EC (91%) are female. The median age at which control of viraemia was achieved was 6.5yrs. Five of these 11 (46%) children lost control of viraemia at a median age 12.9yrs. Children who maintained control of viraemia had significantly higher absolute CD4 counts in the period of EC than those who lost viraemic control. Based on the data available from cross-sectional cohorts, the prevalence of EC in paediatric infection is estimated to be 5-10-fold lower than in adults. Conclusion: These data indicate that, whilst paediatric elite control can be achieved, compared to adult EC this occurs rarely, and takes some years after infection to achieve. Also, loss of immune control arises in a high proportion of children and often relatively rapidly. These findings are consistent with the more potent antiviral immune responses observed in adults and in females.
Issue Date: 2-Jan-2019
Date of Acceptance: 11-Sep-2018
URI: http://hdl.handle.net/10044/1/71754
DOI: https://doi.org/10.1097/QAD.0000000000002043
ISSN: 0269-9370
Publisher: Lippincott Williams & Wilkins
Start Page: 67
End Page: 75
Journal / Book Title: AIDS
Volume: 33
Issue: 1
Copyright Statement: © 2019 Lippincott Williams & Wilkins, Inc. This is a non-final version of an article published in final form in https://doi.org/10.1097/QAD.0000000000002043
Keywords: Science & Technology
Life Sciences & Biomedicine
Immunology
Infectious Diseases
Virology
elite control
HIV
infant
paediatrics
viral control
HUMAN-IMMUNODEFICIENCY-VIRUS
LOW-LEVEL VIREMIA
RNA LEVELS
ASSOCIATION
MORTALITY
ABSENCE
GENDER
DETERMINANTS
INDIVIDUALS
CESSATION
Science & Technology
Life Sciences & Biomedicine
Immunology
Infectious Diseases
Virology
elite control
HIV
infant
paediatrics
viral control
HUMAN-IMMUNODEFICIENCY-VIRUS
LOW-LEVEL VIREMIA
RNA LEVELS
ASSOCIATION
MORTALITY
ABSENCE
GENDER
DETERMINANTS
INDIVIDUALS
CESSATION
Virology
06 Biological Sciences
11 Medical and Health Sciences
17 Psychology and Cognitive Sciences
Publication Status: Published
Embargo Date: 2020-01-02
Appears in Collections:Faculty of Medicine



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