HIV is not transmitted under fully suppressive therapy: The Swiss Statement – eight years later

Vernazza, Pietro; Bernard, Edwin J

doi:10.4414/smw.2016.14246

Cited by 21 publications

(19 citation statements)

References 17 publications

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“…Although still controverted (353) natural conception is now additionally proposed in some countries as a relatively safe/low risk alternative when specific conditions are met (e.g. undetectable viral loads in blood and semen for over 6 months) (708). Semen parameters in HIV+ men attending fertility clinics have been extensively studied.…”

Section: Human Immunodeficiency Virusmentioning

confidence: 99%

From Ancient to Emerging Infections: The Odyssey of Viruses in the Male Genital Tract

Tortorec

Matusali

Mahé

et al. 2020

Physiological Reviews

103

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The male genital tract (MGT) is the target of a number of viral infections that can have deleterious consequences at the individual, offspring, and population levels. These consequences include infertility, cancers of male organs, transmission to the embryo/fetal development abnormalities, and sexual dissemination of major viral pathogens such as human immunodeficiency virus (HIV) and hepatitis B virus. Lately, two emerging viruses, Zika and Ebola, have additionally revealed that the human MGT can constitute a reservoir for viruses cleared from peripheral circulation by the immune system, leading to their sexual transmission by cured men. This represents a concern for future epidemics and further underlines the need for a better understanding of the interplay between viruses and the MGT. We review here how viruses, from ancient viruses that integrated the germline during evolution through old viruses (e.g., papillomaviruses originating from Neanderthals) and more modern sexually transmitted infections (e.g., simian zoonotic HIV) to emerging viruses (e.g., Ebola and Zika) take advantage of genital tract colonization for horizontal dissemination, viral persistence, vertical transmission, and endogenization. The MGT immune responses to viruses and the impact of these infections are discussed. We summarize the latest data regarding the sources of viruses in semen and the complex role of this body fluid in sexual transmission. Finally, we introduce key animal findings that are relevant for our understanding of viral infection and persistence in the human MGT and suggest future research directions.

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Section: Human Immunodeficiency Virusmentioning

confidence: 99%

From Ancient to Emerging Infections: The Odyssey of Viruses in the Male Genital Tract

Tortorec

Matusali

Mahé

et al. 2020

Physiological Reviews

103

View full text Add to dashboard Cite

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“…In the slightly smaller study 'Opposite attract' that included serodiscordant MSM couples from Australia, Thailand and Brazil, no HIV transmissions were observed in approximately 17,000 episodes of condomless sex [21]. The non-existent risk of sexual transmission in well-treated HIV is also supported by the fact that no such cases have been documented [80].…”

Section: Antiretroviral Treatment and Risk Of Transmissionmentioning

confidence: 98%

Antiretroviral treatment for HIV infection: Swedish recommendations 2019

Eriksen

Carlander

Albert

et al. 2020

Infectious Diseases

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The Swedish Reference Group for Antiviral Therapy (RAV) published recommendations for the treatment of HIV infection in this journal most recently in 2017. An expert group under the guidance of RAV here provides updated recommendations. The most important updates in the present guidelines are the following: (a) The risk of HIV transmission through condomless sex from individuals with fully suppressed HIV viral load is effectively zero. (b) Pre-exposure prophylaxis (PrEP) is recommended for groups with a high risk of HIV infection. (c) Since the last update, two new substances have been registered: bictegravir and doravirine. (d) Dual treatment may be an alternative in selected patients, using lamivudine þ dolutegravir or lamivudine þ boosted darunavir/atazanavir. As with previous publications, recommendations are evidence-graded in accordance with the Oxford Centre for Evidence Based Medicine. This document does not cover treatment of opportunistic infections and tumours.

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“…Rodger et al conducted a 1.3 years follow‐up study in 1166 sero‐discordant men who have sex with men (MSM) couples from 14 European countries, and found that in 11 cases of seroconversion among sexual partners of HAART treated patients with VL <200, viral transmission did not occur from their sexual partners, according to virus genotyping. Because the sexual transmission risk after the treatment is mainly dependent on the VL, American and Australian scientists have proposed a prevention strategy to reduce the sexual transmission through HAART, and further suggested that full viral suppression should aim to zero transmission ("undetectable equals untransmittable", "U = U") …”

Section: Introductionmentioning

confidence: 99%

Effect of early highly active antiretroviral therapy on viral suppression among newly diagnosed men who have sex with men living with human immunodeficiency virus in Xi'an, China

Wei

Zhang

Santella

et al. 2019

Journal of Medical Virology

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Background: The number of men who have sex with men (MSM) living with human immunodeficiency virus (HIV) in China has increased rapidly and thus immediate highly active antiretroviral therapy (HAART) after diagnosis was implemented as a strategy to reduce the HIV transmission. Methods: MSM who were diagnosed with HIV and received HAART between 2013 to 2015 in Xi'an were divided into three groups (>350, 200-350, and <200 cell/μL) according to their baseline CD4+ T cell count. The time of follow-up was calculated from the first date of receiving HAART to December 31, 2016. The CD4+ T cell count was detected with 1 week before or after HAART. The plasma viral loads were tested after 1, 2, and 3 years of treatment. Results: Of 1442 subjects who received HAART, 690 (47.9%) cases were in >350 cell/μL group, whereas 400 (27.7%) cases and 352 (24.4%) cases were in the 200-350 cell/μL group and <200 cell/μL group, respectively. After 1 year of treatment, the viral suppression rate in the <200 cell/μL group was 91.1%, which was significantly lower than the other two groups. The logistic regression results show that the >350 cell/μL group and 200-350 cell/μL group predicted higher viral suppression rates. Conclusions: Baseline CD4+ T cell count more than 350 cell/μL can improve viral suppression among MSM living with HIV. Furthermore, to reduce the transmission risk, the treatment compliance of people living with HIV with high CD4+ T cell levels should be improved, and their diagnosis to the treatment time should be decreased.

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HIV is not transmitted under fully suppressive therapy: The Swiss Statement – eight years later

Cited by 21 publications

References 17 publications

From Ancient to Emerging Infections: The Odyssey of Viruses in the Male Genital Tract

From Ancient to Emerging Infections: The Odyssey of Viruses in the Male Genital Tract

Antiretroviral treatment for HIV infection: Swedish recommendations 2019

Effect of early highly active antiretroviral therapy on viral suppression among newly diagnosed men who have sex with men living with human immunodeficiency virus in Xi'an, China

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