ArticleEBioMedicine2021
A high prevalence of potential HIV elite controllers identified over 30 years in Democratic Republic of Congo.
Article in EBioMedicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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15 citing papers in PubMed.
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- The performance of low HIV viral load values for the diagnosis of acute HIV infection in the Beijing PRIMO cohort.BMC infectious diseases · 2025Article
- High peak viraemia followed by spontaneous HIV-1 control in women living with HIV-1 subtype A1 in East Africa.Journal of the International AIDS Society · 2025Article
- Human models that inform antiretroviral therapy-free remission with perinatally acquired HIV infection.Current opinion in HIV and AIDS · 2025Review
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- Pregnancy Management in HIV Viral Controllers: Twenty Years of Experience.Pathogens (Basel, Switzerland) · 2024Article
- Impact of ChAdOx1 or DNA Prime Vaccination on Magnitude, Breadth, and Focus of MVA-Boosted Immunogen-Specific T Cell Responses.Vaccines · 2024Article
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- Limited awareness of HIV Status hinders uptake of treatment among female sex workers and sexually exploited adolescents in Wau and Yambio, South Sudan.BMC public health · 2023Article
- HIV Incidence, Recent HIV Infection, and Associated Factors, Kenya, 2007-2018.AIDS research and human retroviruses · 2023Article
- TheFrontiers in immunology · 2023Article
- Purifying selection decreases the potential for Bangui orthobunyavirus outbreaks in humans.Virus evolution · 2023Article
- The Abbott Pandemic Defense Coalition: a unique multisector approach adds to global pandemic preparedness efforts.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2022Article
- The New Kid on the Block: HLA-C, a Key Regulator of Natural Killer Cells in Viral Immunity.Cells · 2021Review
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Abstract
backgroundIn-depth analysis of the HIV pandemic at its epicenter in the Congo basin has been hampered by 40 years of political unrest and lack of functional public health infrastructure. In recent surveillance studies (2017-18), we found that the prevalence of HIV in Kinshasa, Democratic Republic of Congo (11%) far exceeded previous estimates.
methods10,457 participants were screened in Kinshasa with rapid tests from 2017-2019. Individuals confirmed as reactive by the Abbott ARCHITECT HIV Ag/Ab Combo assay (n=1968) were measured by the Abbott RealTime HIV-1 viral load assay. Follow up characterization of samples was performed with alternate manufacturer viral load assays, qPCR for additional blood borne viruses, unbiased next generation sequencing, and HIV Western blotting.
findingsOur data suggested the existence of a significant cohort (n=429) of HIV antibody positive/viral load negative individuals. We systematically eliminated collection site bias, sample integrity, and viral genetic diversity as alternative explanations for undetectable viral loads. Mass spectroscopy unexpectedly detected the presence of 3TC antiviral medication in approximately 60% of those tested (209/354), and negative Western blot results indicated false positive serology in 12% (49/404). From the remaining Western blot positives (n=53) and indeterminates (n=31) with reactive Combo and rapid test results, we estimate 2.7-4.3% of infections in DRC to be potential elite controllers. We also analyzed samples from the DRC collected in 1987 and 2001-03, when antiretroviral drugs were not available, and found similarly elevated trends.
interpretationViral suppression to undetectable viral loads without therapy occurs infrequently in HIV-1 infected patients around the world. Mining of global data suggests a unique ability to control HIV infection arose early in central Africa and occurs in <1% of founder populations. Identification of this group of elite controllers presents a unique opportunity to study potentially novel genetic mechanisms of viral suppression.
fundingAbbott Laboratories funded surveillance in DRC and subsequent research efforts. Additional funding was received from a MIZZOU Award from the University of Missouri. Research was supported in part by the Division of Intramural Research, National Institute of Allergy and Infectious Diseases, NIH.
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