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Sophia Osawe (BSc, AIMLS)
Institute of Human Virology, NigeriaNigerian Canadian Collaboration on AIDS Vaccines (NICCAV)
Study Coordinator
Discordant Couples Cohort Is Still Relevant For HIV Vaccine Studies Despite Low Transmission Rates;
Canadian–Nigerian Experience
Afri-Can Synchronicity Forum 17-19 Jan. 2012, Entebbe
CHVI/CIDAGHRI/CHVI/CIDA/IDRC/CIHR
Background
Discordant couples have been known to be medium risk group for HIV transmission.
This group is suitable for HIV vaccine trials due to: the natural exposure high retention rates recorded in the past.
A cohort of HIV sero-negative volunteers of discordant couples has been developed in Nigeria to record :behavioral data, risk factors, HIV incidence, STI infections, and retention rates.
GHRI/CHVI/CIDA/IDRC/CIHR
Study flow
Screening(Eligibility criteria)
Consent & Enroll
Eligible?Sero-discordance
STOP
11 study visits (2 years FU)
Complete
*Counseling *Referrals (community)
No
Yes
Medical examination and labs supporting HIV+ partners
GHRI/CHVI/CIDA/IDRC/CIHR
● Behavioral data ●Medical history/exams ●Serology tests ●Safety Labs
MethodsLaboratory:
HIV negative Serology tests Safety Labs- CBC, LFT and KFTClinical: Medical History and Examinations Referrals to appropriate clinics
HIV positive partners- CD4 counts (Partec Cyflow SL3 counter) Viral Loads (ROCHE COBAS Taqman 96; HIV v2.0)
GHRI/CHVI/CIDA/IDRC/CIHR
Results- Risk FactorsCondom Use Female Male Total
Always 57 70 127 (40.3%)
Never 34 47 81 (25.7%)
Sometimes 66 41 107 (34.0%)
Total 157 158 315 (100%)
STIs # Enrolled # that reported STI in partners
# tested positive for Syphilis
Female 157 12 3Male 158 4 1Total 315 16 (5.1%) 4 (1.3%)
GHRI/CHVI/CIDA/IDRC/CIHR
Results- Risk factors (HIV+ partners)
Gender HIV+ partners
# on ARVs
Mean CD4 (cells/µl)
<10,000 cps/ml
>10,000 – 1,638,427 cps/ml
Female 131 125 467 69 28Male 114 106 394 75 17Total 245 231
(94.3%)450 134
(74.9%)45(25.1%)
HIV incidence :The recorded incidence in this cohort is 0.6%
GHRI/CHVI/CIDA/IDRC/CIHR
Conclusion
1. Despite antiretroviral treatment, sero- negative partners are still at risk of getting infected mainly due to:
Inconsistent and lack of condom use.A high percentage of sero-positive partners still have
detectable viral loads.Prevailing STIs among HIV negative and HIV positive partners
2. Sero-discordant couple cohort remains an important natural adult model for transmission studies; and
3. ..presents an opportunity to test vaccines in HIV exposed adults
GHRI/CHVI/CIDA/IDRC/CIHR
Acknowledgements
This work was carried out with support from the Global Health Research Initiative (GHRI), a research funding partnership composed of the Canadian Institutes of Health Research, the Canadian International Development Agency, and the International Development Research Centre.
• PLASVIREC’s Research team: Counseling, Clinical, Data & Lab team
• All the discordant couples that volunteered for this study• Dr. Pam Datong • Dr. Evaezi Okpokoro• Dr. Alash’le Abimiku
GHRI/CHVI/CIDA/IDRC/CIHR
GHRI/CHVI/CIDA/IDRC/CIHR