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Low-Level Viremia Early in HIV Infection

Chen, Iris BS*; Cummings, Vanessa BS, MT (ASCP)*; Fogel, Jessica M. PhD*; Marzinke, Mark A. PhD*; Clarke, William PhD*; Connor, Matthew B. MS; Griffith, Sam MAT; Buchbinder, Susan MD§; Shoptaw, Steven PhD; del Rio, Carlos MD; Magnus, Manya PhD, MPH#; Mannheimer, Sharon MD**; Wheeler, Darrell P. PhD, MPH, ASCW††; Mayer, Kenneth H. MD‡‡; Koblin, Beryl A. PhD§§; Eshleman, Susan H. MD, PhD*

JAIDS Journal of Acquired Immune Deficiency Syndromes: December 1st, 2014 - Volume 67 - Issue 4 - p 405–408
doi: 10.1097/QAI.0000000000000298
Brief Report: Clinical Science

Abstract: HIV RNA levels are usually high early in HIV infection. In the HPTN 061 study, men were tested for HIV infection every 6 months; 6 (21.4%) of 28 men who acquired HIV infection during the study had low or undetectable HIV RNA at the time of HIV diagnosis. Antiretroviral drugs were not detected at the time of HIV diagnosis. False-negative HIV test results were obtained for 2 men using multiple assays. Antiretroviral drug resistance mutations were detected in HIV from 1 man. Additional studies are needed to identify factors associated with low HIV RNA levels during early HIV infection.

*Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD;

Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA;

Science Facilitation Department, FHI 360, Research Triangle Park, NC;

§San Francisco Department of Public Health, Bridge HIV, San Francisco, CA;

Department of Family Medicine, University of California Los Angeles, Los Angeles, CA;

Department of Global Health, Emory University Rollins School of Public Health, Atlanta, GA;

#Department of Epidemiology and Biostatistics, The George Washington University, Washington, DC;

**Department of Medicine, Harlem Hospital, Columbia University, Mailman School of Public Health, New York, NY;

††Graduate School of Social Work, Loyola University Chicago, Chicago, IL;

‡‡The Fenway Institute, Fenway Health/Infectious Disease Division, Beth Israel Deaconess Medical Center/Department of Medicine, Harvard Medical School, Boston, MA;

§§Laboratory of Infectious Disease Prevention, Lindsley F. Kimball Research Institute, New York Blood Center, New York, NY.

Correspondence to: Susan H. Eshleman, MD, PhD, Department of Pathology, Johns Hopkins University School of Medicine, Ross Building, Room 646, 720 Rutland Avenue, Baltimore, MD 21205 (e-mail:

Supported by the HIV Prevention Trials Network, sponsored by the National Institute of Allergy and Infectious Diseases (NIAID), the National Institute of Mental Health (NIMH), and the National Institute of Drug Abuse (NIDA), Office of AIDS Research, the National Institutes of Health (NIH, Grant Nos. U01-AI068613/UM1-AI068613, U01-AI068617/UM1-AI068617, and U01-AI068619/UM1-AI068619). Additional support was provided by R01-AI095068.

The authors have no conflicts of interest to disclose.

I.C.: coordinated the study, performed HIV genotyping, analyzed the data, and wrote the article; V.C.: coordinated HIV diagnostic and viral load testing; J.M.F.: assisted with analysis of ARV drug data; M.A.M.: coordinated and reviewed results for ARV drug testing; W.C.: coordinated and reviewed results for ARV drug testing; M.B.C.: data analyst for HPTN 061; S.G.: study coordinator for HPTN 061; S.B.: site PI for HPTN 061; S.S.: site PI for HPTN 061; C.d.R.: site PI for HPTN 061; M.M.: site PI for HPTN 061; S.M.: site PI for HPTN 061; D.P.W.: protocol Co-Chair for HPTN 061; K.H.M.: protocol Co-Chair for HPTN 061, site PI; B.A.K.: protocol Chair for HPTN 061, site PI; and S.H.E. designed the study, reviewed study data, and wrote the article.

Received February 18, 2014

Accepted May 30, 2014

© 2014 by Lippincott Williams & Wilkins