Safety and tolerability of inguinal lymph node biopsy in individuals with acute HIV infection in Thailand

the RV254/SEARCH010 study groups

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Introduction: Latent HIV reservoirs are rapidly established in lymphoid tissues during acute HIV infection (AHI). Sampling these tissues provides important information about HIV pathogenesis. This period is associated with viral replication and immune activation that may affect procedure-related adverse events (AEs). We examined the safety and tolerability of inguinal lymph node (LN) biopsy in research participants with AHI in Bangkok, Thailand. Methods: Between 2013 and 2016, 67 AHI participants in the RV254/ SEARCH010 study underwent at least one optional inguinal LN biopsy during AHI at the baseline visit and/or after antiretroviral therapy (median 48 weeks after antiretroviral therapy). Biopsy-related AEs were graded according to NIH Division of AIDS guidelines. Poisson regression was used to calculate incidence rate ratios and 95% confidence intervals to evaluate associations of demographic and HIV characteristics, procedure timing, and repetition with AE incidence. Results: Of the 67 participants, 97% were male with a median age of 26. Among 78 LN biopsies (39 at baseline and 39 at follow-up), 10 (12.8%) AEs were reported: 6 (7.7%) grade 1 and 4 (5.1%) grade 2. The AEs were biopsy-site discomfort (n = 8, 10.2%) and hematoma (n = 2, 2.6%). No factors were significantly associated with AE incidence. All biopsy-related AEs were transient and self-limited. Conclusions: Inguinal LN biopsies were safe and well tolerated in mostly Thai men with AHI. As LN biopsies become an integral part of HIV research, this study provides information to participants, researchers, and institutional review boards that these samples can be safely obtained.

Original languageEnglish (US)
Pages (from-to)244-248
Number of pages5
JournalJournal of Acquired Immune Deficiency Syndromes
Volume79
Issue number2
DOIs
StatePublished - 2018

Bibliographical note

Funding Information:
Supported by cooperative agreements (W81XWH-07-2-0067, W81XWH-11-2-0174) between the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., and the US Department of the Army and by an intramural grant from the Thai Red Cross AIDS Research Center. The US Army Medical Research Acquisition Activity (820 Chandler Street, Fort Detrick, MD 21702-5014) is the awarding and administering acquisition office for the cooperative agreement. It has also been funded in part with federal funds from the National Cancer Institute, National Institutes of Health, under Contract No. HHSN261200800001E. This research was supported in part by awards from the National Institute of Allergy and Infectious Diseases (R01AI125127) and The National Institute of Neurologic Disorders and Stroke (R01NS084911). Antiretroviral therapy was supported by the Thai Government Pharmaceutical Organization, Gilead, Merck, and ViiV Healthcare.

Funding Information:
Supported by cooperative agreements (W81XWH-07-2-0067, W81XWH-11-2-0174) between the Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., and the US Department of the Army and by an intramural grant from the Thai Red Cross AIDS Research Center. The US Army Medical Research Acquisition Activity (820 Chandler Street, Fort Detrick, MD 21702-5014) is the awarding and administering acquisition office for the cooperative agreement. It has also been funded in part with federal funds from the National Cancer Institute, National Institutes of Health, under Contract No. HHSN261200800001E. This research was supported in part by awards from the National Institute of Allergy and Infectious Diseases (R01AI125127) and The National Institute of Neurologic Disorders and Stroke (R01NS084911). Antiretroviral therapy was supported by the Thai Government Pharmaceutical Organization, Gilead, Merck, and ViiV Healthcare. The authors thank their study participants and staff from the Thai Red Cross AIDS Research Centre, Chulalongkorn University, and AFRIMS for their valuable contributions to this study. They are grateful to the Thai Government Pharmaceutical Organization, ViiV Healthcare, Gilead, and Merck for providing the antiretrovirals for this study. The RV254/SEARCH 010 Study Group includes: from SEARCH/ TRCARC/HIV-NAT: Praphan Phanuphak, Nipat Teeratakulpisarn, Mark de Souza, James Fletcher, Ponpen Tantivitayakul, Sasiwimol Ubolyam, Pacharin Eamyoung, Jintana Intasan, Duanghathai Sutthichom, Peeriya Prueksakaew, Somprartthana Rattanamanee, Suwanna Puttamaswin, Somporn Tipsuk, Khunthalee Benjapornpong, Nisakorn Ratnaratorn, Chutharat Munkong, Kamonkan, and Tanjnareel; from AFRIMS: Robert J O'Connell, Siriwat Akapirat, Rapee Trichavaroj, Bessara Nuntapinit; from MHRP: Merlin Robb, Madelaine Ouellette, and Oratai Butterworth.

Publisher Copyright:
© 2018 The Author(s).

Keywords

  • Acute HIV infection
  • Lymph node biopsy
  • Research risk

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