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, EntebbeCHVI/CIDA

GHRI/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