The viral load setpoint (VLS) is an important predictor of HIV disease progression, but there is a lack of information regarding the VLS and its possible determinants in African populations.
Initially HIV negative adults from three distinct groups (female barworkers, females and males from the general population) were followed for up to four years. The VLS was calculated for 108 seroconverters and associations of the VLS with possible risk factors were analyzed using univariate and multivariate regression.
The median VLS for female barworkers, females and males from the general population were 69,850, 28,600 and 158,000 RNA copies/ml respectively. Significant associations with an elevated viral load were observed for male gender (Risk Ratio (RR)=1.83, 95% confidence interval (95%CI)=1.14–2.93), the expression of harmful HLA I alleles (RR=1.73, 95%CI=1.13–2.66) and multiple infection with different HIV-1 subtypes (RR=1.65, 95%CI =1.03–2.66). Barworkers were considerably more often infected with different HIV-1 subtypes than participants from the general population.
Our study confirms that gender and the expression of different HLA class I alleles are important determinants of the viremia at VLS and it also corroborates an earlier finding that multiple infection with different HIV-1 subtypes is associated with a higher VLS.