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Identification and characterization of HIV positive Ethiopian elite controllers in both Africa and Israel
Author(s) -
Kiros YK,
Elinav H,
Gebreyesus A,
Gebremeskel H,
Azar J,
Chemtob D,
Abreha H,
Elbirt D,
Shahar E,
Chowers M,
Turner D,
Grossman Z,
Haile A,
Sutton RE,
Maayan SL,
Wolday D
Publication year - 2019
Publication title -
hiv medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.53
H-Index - 79
eISSN - 1468-1293
pISSN - 1464-2662
DOI - 10.1111/hiv.12680
Subject(s) - medicine , cohort , viral load , human immunodeficiency virus (hiv) , cohort study , antiretroviral therapy , population , demography , immunology , environmental health , sociology
Objectives HIV elite controllers ( EC s) are a unique subgroup of HIV ‐positive patients who are long‐term virologically suppressed in the absence of antiretroviral treatment (ART). The prevalence of this subgroup is estimated to be < 1%. Various cohorts of EC s have been described in developed countries, most of which have been demographically heterogeneous. The aim of this study was to identify EC s in two large African cohorts and to estimate their prevalence in a relatively genetically homogenous population. Methods We screened two cohorts of HIV ‐positive Ethiopian patients. The first cohort resided in Mekelle, Ethiopia. The second was comprised of HIV ‐positive Ethiopian immigrants in Israel. In the Mekelle cohort, ART ‐naïve subjects with stable CD 4 counts were prospectively screened using two measurements of viral load 6 months apart. Subjects were defined as EC s when both measurements were undetectable. In the Israeli cohort, subjects with consistently undetectable viral loads (mean of 17 viral load measurements/patient) and stable CD 4 count > 500 cells/μL were defined as EC s. Results In the Mekelle cohort, 16 of 9515 patients (0.16%) fitted the definition of EC , whereas seven of 1160 (0.6%) in the Israeli cohort were identified as EC s ( P = 0.011). Conclusions This is the first large‐scale screening for HIV ‐positive ECs to be performed in entirely African cohorts. The overall prevalence of ECs is within the range of that previously described in developing countries. The significant difference in prevalence between the two cohorts of similar genetic background is probably a consequence of selection bias but warrants further investigation into possible environmental factors which may underlie the EC state.