776-W. Gender Difference in Early Plasma HIV-1 RNA Levels among HIV-1-Infected African Seroconverters

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Session 102 Poster Session
Effect of Gender/Sex on Viral Load, Pharmacokinetics and Responses to Antiretroviral Therapy
Session Time: 4:30-6:30 pm
Room 4E-F

776-W.

Gender Difference in Early Plasma HIV-1 RNA Levels among HIV-1-Infected African Seroconverters
C. Danel*¹, A. Minga¹, F. Rouet², C. Huët¹, D. Bonard^{2, 3}, T. A. Toni³, L. Dohoun¹, Y. Abo¹, F. Dabis⁴, and R. Salamon⁴ for the PRIMO-CI Study Group
¹PAC-CI; ²CeDReS; ³CIRBA, Abidjan, Côte d’Ivoire; and ⁴INSERM U330, Bordeaux, France

Background: Studies performed in developed countries have shown that median plasma HIV-1 RNA viral load (VL) after seroconversion was significantly lower in women than in men among injecting-drug users. Our objective was to study the possible association between VL and gender in Côte d’Ivoire, West Africa.
Methods: VL (Roche Amplicor HIV-1 Monitor, 1.5 version, Indianapolis, IN with a 200 copies/mL threshold) was carried out among 104 HIV-1 seroconverters regular blood donors enrolled into a prospective cohort. All but 1 were infected through heterosexual contacts. Gender-stratified analysis of baseline VL was adjusted for both time since seroconversion (estimated as the mid-point between the last negative and the first positive HIV serological testing) and CD4 count.
Results: The median time interval between the date of seroconversion and inclusion was not statistically different for the 83 men (7.7 months) and the 21 women (12.6 months, p=0.13). The median initial CD4+ count at entry in the cohort did not differ by gender (541 and 493/mm³ for men and women, respectively; p=0.27). By contrast, in a linear regression adjusted for the 2 above-mentioned variables, the median initial VL was 39,810 copies/mL in men but only 6310 in women (p=0.002), a 0.8 log₁₀ difference according to gender. The median duration of follow-up was not different between men (28.3 months) and women (32.8 months, p=0.52). Whereas the median initial VLs were not statistically different between men (n=16) and women (n=5) in whom HIV-1 disease subsequently progressed to stage B or C (50,119 vs 63,096 copies/mL, respectively; p=0.38), a significant difference was observed when considering men (n=67) and women (n=16) in whom HIV-1 disease did not progress (39,810 vs 5012 copies/mL, respectively; p=0.001).
Conclusions: Our data, obtained among a heterosexually infected West African population, suggest that the baseline VL is lower in women than in men. In Africa, because of the improved access to highly active antiretroviral treatment, the identification of simple determinants allowing a better management of adults living with HIV/AIDS is needed. Gender could be one of those.