Current Organisation

Uganda National Health Research Organisation (UNHRO)

Current Job Title

Scientist

Biography

Project Title

Association of early immune responses with virological control in acute /early and following HIV-1 infection (KILGORIS)

EDCTP Project Call

Career Development Fellowship (CDF)

Host Organisation

Project Objectives

The aims of KILGORIS are: 1. To identify at least 20 participants in acute HIV-1 infection. 2. To determine the association of CD8 T cell subsets with plasma viral load and CD4 trajectories following acute and early HIV infection. 3. To determine the association of cell death mechanisms with T cells following acute and early HIV infection. 4. To determine the viral replication inhibitory properties of CD8 T cell subsets following acute and early HIV-1.

Study Design

Observational

Project Summary

Background Acute HIV infection is characterized by high viremia enabling easier transmission per coital act. Therefore, identifying acute HIV infected individuals and initiating them on ART early, may lower the number of new HIV infected individuals. Setting & Methods Between February and December 2021, we collaborated with 10 health centers in South Western Uganda and investigated for HIV RNA using the GeneXpert HIV-1 Viral Load assay in individuals who had a non-reactive RDT Determine test (i.e. HIV negative) or inconclusive test result. Study activities were suspended (18/06/2021 to 15/09/2021) due to travel restrictions aimed at reducing levels of connectivity between and within communities, to curb the rising number of COVID-19 infections. Results Fourteen of 4,935 ‘left-over’ plasma samples retested were reactive with a mean pVL of 1.5X106 copies per ml. Eleven of the 14 participants were females. Using a formula from Brookmeyer and Quinn to estimate HIV incidence, the overall HIV incidence per (100) was 7.4 (95% CI: 4.3-12.5): higher for females at 9.4 (95% CI: 5.2-16.9) compared to 4.2 (95% CI: 1.3-12.9) for males. The HIV Incidence per (100) was 7.8 (95% CI: 3.7-16.4) before lockdown and 7.0 (3.3-14.7) after the travel restrictions were lifted. Conclusion We demonstrate that HIV incidence can be determined without assembling a longitudinal cohort. GeneXpert HIV-1 Viral Load assay can detect acute infection usually missed by 3rd generation RDT to initiate individuals on ART before immune damage. There is no evidence that COVID-19 restrictions was associated with increased HIV Incidence rates in these communities. https://www.lshtm.ac.uk/research/units/mrc-uganda/projects

Results & Outcomes