Viral load and CD4+ T-cell dynamics in primary HIV-1 subtype C infection

Vladimir Novitsky, Elias Woldegabriel, Lemme Kebaabetswe, Raabya Rossenkhan, Busisiwe Mlotshwa, Caitlin Bonney, Mariel Finucane, Rosemary Musonda, Sikhulile Moyo, Carolyn Wester, Erik Van Widenfelt, Joseph Makhema, Stephen Lagakos, M. Essex

Research output: Contribution to journalArticlepeer-review

33 Citations (Scopus)


BACKGROUND: Most knowledge of primary HIV-1 infection is based on subtype B studies, whereas the evolution of viral parameters in the early phase of HIV-1 subtype C infection is not well characterized. METHODS: The kinetics of viral RNA, proviral DNA, CD4 T-cell count, and subsets of CD4 T cells expressing CCR5 or CXCR4 were characterized in 8 acute and 62 recent subtype C infections over the first year postseroconversion. RESULTS: The viral RNA peak was 6.25 ± 0.92 log10 copies per milliliter. After seroconversion, heterogeneity among acute cases was evident by patterns of change in viral load and CD4 T-cell count over time. The patterns were supported by the rate of viral RNA decline from peak (P = 0.022), viral RNA means (P = 0.005), CD4 levels (P < 0.001), and CD4 decline to 350 (P = 0.011) or 200 (P = 0.046). Proviral DNA had no apparent peak and its mean was 2.59 ± 0.69 log10 per 106 peripheral blood mononuclear cell. In recent infections, viral RNA set point was 4.00 ± 0.97 log10 and viral RNA correlated inversely with CD4 T cells (P < 0.001) and directly with proviral DNA (P < 0.001). CONCLUSIONS: Distinct patterns of viral RNA evolution may exist shortly after seroconversion in HIV-1 subtype C infection. The study provides better understanding of the early phase of subtype C infection.

Original languageEnglish
Pages (from-to)65-76
Number of pages12
JournalJournal of Acquired Immune Deficiency Syndromes
Issue number1
Publication statusPublished - Jan 1 2009

All Science Journal Classification (ASJC) codes

  • Infectious Diseases
  • Pharmacology (medical)


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