Heterosexual Transmission of Human Immunodeficiency Virus: Variability of Infectivity throughout the Course of Infection

Leynaert, Bénédicte; Downs, Angela M.; Vincenzi, Isabelle De

doi:10.1093/oxfordjournals.aje.a009564

Cited by 227 publications

(163 citation statements)

References 24 publications

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“…Men were five times more commonly affected than women. The most common age group affected was the 31-40 years; this is consistent with the findings of Leynaert et al [17] and Kumar [18] et al who observed the highest incidence of HIV in the late twenties and thirties.…”

Section: Age and Sex Incidencesupporting

confidence: 90%

Oral Microflora: A Comparative Study in HIV and Normal Patients

Hegde

Kumar

Bhat

et al. 2011

Indian J Otolaryngol Head Neck Surg

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The study was designed to compare the oral microbiota in normal and HIV-infected individuals. The study tries to establish a significant shift in oral microflora in HIV-infected patients. Antibiotic sensitivity testing was performed to establish any rise in resistance against the antibiotics. It was a two and half year prospective study conducted in a tertiary care centre. The study group consisted of eighty subjects divided into two groups of control and HIV. The age range for this group was 9-75 years. The mean age in this group was 39.7 years. The male:female ratio was 2.75:1. Tuberculosis was the most common opportunistic infection in patients with HIV infection. The most common commensal micro organism isolated was the Viridans streptococci in 60% followed by Streptococcus pneumoniae in 23.33%. HIV Group: The most common commensal micro organism isolated was the Viridans streptococci in 42%; this was followed by the Micrococci spp. in 22% cases. S. pneumoniae was isolated in 6% of cases. The colony count for Viridans streptococci showed a heavy growth in 55.56% of cases in controls whereas the same in HIV group was 62.5%. Micrococcus spp. was isolated from 11 subjects in HIV group while it was not isolated from the controls. 50% subjects in the HIV group showed a heavy growth of Klebsiella spp. whereas controls showed only moderate and scanty growth. In patients with CD4? T cell count less than 50 cells/ll we found a heavy colonization of the oral cavity with Micrococcus spp., Acinetobacter and Klebsiella spp. Viridans streptococcus was not isolated in any of the patients with CD4? T cell count less than 50 cells/ll. As CD4? T cells counts improved to 51-100 cells/ll Viridans streptococcus colonies returned and 37.5% patients showed a heavy growth. Micrococcus spp. colonies were isolated till the CD4? T cells improved up to 300 cells/ll. At counts [ 300 cells/ll the oral microbiota became comparable to that of the controls. Many of the opportunistic infections in HIV are caused by commensal bacteria which are otherwise harmless in a normal individual. Our study is unique in that such a study of the oral commensals in HIV patients has never been reported. We found an increased colonization of the oral cavity by Micrococcus spp. which is a normal commensal of the skin.

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Section: Age and Sex Incidencesupporting

confidence: 90%

Oral Microflora: A Comparative Study in HIV and Normal Patients

Hegde

Kumar

Bhat

et al. 2011

Indian J Otolaryngol Head Neck Surg

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“…Retrospective cohort studies of patients infected by sexual contact (89) or blood transfusion (S75) have confirmed significantly increased risk of infection among those exposed to index cases with acute or recent infection. Recently, Wawer and colleagues (80) examined the link between acute disease stage and transmission in a remarkable study of couples in Rakai, Uganda, who were screened for HIV infection and followed as part of an STD treatment trial.…”

Section: Acute Hiv and Clinical Implications A Unique Role For Acute mentioning

confidence: 99%

Acute HIV revisited: new opportunities for treatment and prevention

Pilcher¹,

Eron²,

Galvin³

et al. 2004

J. Clin. Invest.

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Inability to recognize incident infection has traditionally limited both scientific and public health approaches to HIV disease. Recently, some laboratories have begun adding HIV nucleic acid amplification testing to HIV diagnostic testing algorithms so that acute (antibody-negative) HIV infections can be routinely detected within the first 1–3 weeks of exposure. In this review article, we will highlight critical opportunities for HIV treatment and prevention that are presented by these diagnostic strategies

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“…11 Within the sexual transmission category, anal, oral, and vaginal intercourse bring different levels of risk. 12 An anatomical difference is that semen is retained in the posterior vagina in much greater volume than vaginal fluid is retained postcoitus on the penis. Furthermore, since plasma HIV-1 RNA levels have been reported to be higher in HIV-1-infected men than in HIV-1-infected women 13,14 and the diversity of transmitted viral variants may be greater in women than men, 15 the correlates of female-to-male (FTM) and male-tofemale (MTF) transmission may differ for penile-vaginal intercourse.…”

Section: Introductionmentioning

confidence: 99%

Virologic and Immunologic Determinants of Heterosexual Transmission of Human Immunodeficiency Virus Type 1 in Africa

Fideli

Allen

Musonda

et al. 2001

AIDS Research and Human Retroviruses

332

281

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More than 80% of the world's HIV-infected adults live in sub-Saharan Africa, where heterosexual transmission is the predominant mode of spread. The virologic and immunologic correlates of femaleto-male (FTM) and male-to-female (MTF) transmission are not well understood. A total of 1022 heterosexual couples with discordant HIV-1 serology results (one partner HIV infected, the other HIV uninfected) were enrolled in a prospective study in Lusaka, Zambia and monitored at 3-month intervals. A nested case-control design was used to compare 109 transmitters and 208 nontransmitting controls with respect to plasma HIV-1 RNA (viral load, VL), virus isolation, and CD4 + cell levels. Median plasma VL was significantly higher in transmitters than nontransmitters (123,507 vs. 51,310 copies/ml, p < 0.001). In stratified multivariate Cox regression analyses, the risk ratio (RR) for FTM transmission was 7.6 (95% CI: 2.3, 25.5) for VL ≥ 100,000 copies/ ml and 4.1 (95% CI: 1.2, 14.1) for VL between 10,000 and 100,000 copies/ml compared with the reference group of <10,000 copies/ ml. Corresponding RRs for MTF transmission were 2.1 and 1.2, respectively, with 95% CI both bounding 1. Only 3 of 41 (7%) female transmitters had VL < 10,000 copies/ml compared with 32 of 93 (34%) of female nontransmitters (p < 0.001). The transmission rate within couples was 7.7/100 person-years and did not differ from FTM (61/862 person-years) and MTF (81/978 person-years) transmission. We conclude that the association between increasing plasma viral load was strong for female to male transmission, but was only weakly predictive of male to female transmission in Zambian heterosexual couples. FTM and MTF transmission rates were similar. These data suggest gender-specific differences in the biology of heterosexual transmission.Address reprint requests to: Grace M. Aldrovandi,

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Heterosexual Transmission of Human Immunodeficiency Virus: Variability of Infectivity throughout the Course of Infection

Cited by 227 publications

References 24 publications

Oral Microflora: A Comparative Study in HIV and Normal Patients

Oral Microflora: A Comparative Study in HIV and Normal Patients

Acute HIV revisited: new opportunities for treatment and prevention

Virologic and Immunologic Determinants of Heterosexual Transmission of Human Immunodeficiency Virus Type 1 in Africa

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