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Researchers Determine Factors Associated with Elevated Viral Load Setpoint in Sub-Saharan Africa

August 9, 2010
Gender, genetic background, and multiple HIV infections all factor into the level of virus found in the blood at viral load setpoint (VLS) of HIV-infected individuals in Sub-Saharan Africa.

Gender, genetic background, and multiple HIV infections all factor into the level of virus found in the blood at viral load setpoint (VLS) of HIV-infected individuals in Sub-Saharan Africa according to a recent study published in the Journal of Acquired Immune Deficiency Syndrome (JAIDS). The study was led by Dr. Michael Hoelscher with the Mbyea Medical Research Programme, a partner of the Walter Reed Program-Tanzania and MHRP.

While these findings confirm previous studies from other parts of the world, this information fills a gap in knowledge about African populations.

Researchers examined three populations who were already enrolled in cohort studies in southwestern Tanzania: High-risk women between the ages of 18 and 35 who worked in bars and men and women from the general population in and around Mbeya, Tanzania. From these cohorts, researchers analyzed 46 bar workers, 41 women, and 21 men who became infected with HIV to determine their VLS and additional factors, such as behavior, that might affect their VLS.

Findings showed that males in the study had a 76% higher risk than females of having a high VLS. Participants who had a type of gene, a version of HLA class I alleles that were found harmful in previous studies, were 70% more likely to have a higher VLS. Finally, those who were infected with multiple types of HIV were 65% more likely to have an elevated VLS. Other factors such as age, education level, use of contraceptives or previous HIV testing did not affect the VLS according to the study. 

Additionally, researchers were struck by the number of female bar workers who contracted multiple HIV infections—just over 36%. This finding may warrant further research to determine if multiple infections are transmitted by one person with multiple infections or if the multiple infection is caused by a second HIV infection. This could indicate whether or not a person is more susceptible to HIV infection shortly after he or she was first infected.

Since the amount of virus found in the blood can predict the rate of advancement to AIDS and death, the VLS can be used to identify people at a higher risk for getting sick quickly, which can lead to improved monitoring and the earlier start of antiretroviral therapy.