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Correlates of Plasma HIV-1 RNA Viral Load Among HIV-1 Seropositive Women in Dar es Salaam, Tanzania

Kapiga, Saidi H.; Bang, Heejung; Spiegelman, Donna; Msamanga, Gernard I.; Coley, Jenny; Hunter, David J.; Fawzi, Wafaie W.
JAIDS Journal of Acquired Immune Deficiency Syndromes: July 1st, 2002
doi: 10.1097/01.QAI.0000014767.47046.C8
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This study was conducted to determine the predictors of plasma HIV-1 RNA viral load in HIV-1-positive pregnant women (N = 151) participating in a clinical trial in Tanzania. Viral load was measured at randomization, delivery, and approximately 7 months after delivery. The median viral load was 20,400 copies/mL at baseline, 20,216 copies/mL at delivery, and 19,100 copies/mL 7 months after delivery. The absolute CD4+ lymphocyte count had a strong negative correlation with HIV-1 RNA viral load at baseline (r = -.38), time of delivery (r = -.36), and 7 months after delivery (r = -.53). The association between CD4+ lymphocyte count and HIV-1 RNA viral load was modified by the per capita daily food expenditure in the household, although the difference in viral load became small as the food expenditure in the household increased and was marginally significant at the 75th percentile of the per capita food expenditure. The presence of malaria parasites at baseline was associated with an approximate 116% higher viral load at the three evaluation points (p = .007). Although the long-term effects of malaria on viral load are unknown, prevention of malaria among people living with HIV-1 should be given the highest priority.

Address correspondence and reprint requests to Saidi H. Kapiga, Department of Population and International Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, MA 02115, U.S.A.; e-mail: skapiga@hsph.harvard.edu

Manuscript received September 26, 2001; accepted February 20, 2002.

This work was supported in part by the National Institute of Child Health and Human Development (NICHD R01 32257), and the Fogarty International Center (NIH D43 TW00004).

© 2002 Lippincott Williams & Wilkins, Inc.