Male Viral Load and Heterosexual Transmission of HIV-1 Subtype E in Northern Thailand

Abstract

We evaluated the association between HIV-1 RNA copies/mL in men and heterosexual transmission to their female partners among 493 couples in Thailand. Husbands were identified as HIV-positive when they were screened as blood donors; nearly all were infected with HIV subtype E. Wives had no known risks for HIV infection other than sex with their husbands. In multivariate analysis, each log10 increment of HIV RNA in the man was associated with an 81% increased rate of HIV transmission to his wife (odds ratio = 1.81, 95% confidence interval: 1.33-2.48). No transmission occurred at viral loads below 1094 copies/mL, and a dose-response effect was seen with increasing viral load in the man. In multivariate analysis, a history of a sexually transmitted disease in the man or woman, longer duration of hormonal contraceptive use, and the woman's onset of sexual activity at less than 20 years of age were also associated with increased seropositivity of the wife.

AIDS Vaccines and Preexposure Prophylaxis: Is Synergy Possible?

“…Viral load is the single greatest risk factor for all modes of transmission. 35,36 Sexual transmission of HIV has been closely linked to viral load in the blood of the infected host, [37][38][39][40][41] which probably serves as a surrogate, albeit imperfect, for HIV concentration in the genital tract. 42,43 In addition to lowering plasma viral load to nearly undetectable levels, ART can decrease viral load in genital secretions, 44,45 although patients having a detectable semen HIV load may have no detectable virus in their blood plasma, highlighting the residual risk of HIV-1 transmission during unprotected intercourse.…”

Provision of Test Results and Posttest Counseling at STD Clinics in 24 Health Departments: U.S., 2007

“…26 As previously stated, knowledge of one's HIV-positive serostatus can result in a reduction in risk behaviors, 3 and people with HIV infection who are treated with antiretroviral medications may have lower viral loads, [4][5][6] thereby decreasing their ability to transmit the infection and improving the quality and duration of their life. Therefore, HIV testing and receipt of with HIV were provided posttest counseling, although this percentage was higher (71%) when the test result was newly identified HIV-positive.…”

“…Additionally, antiretroviral therapy can reduce the risk for HIV transmission to the infected person's sexual and needle-sharing partners by reducing the viral load in blood and genital secretions. [4][5][6] CDC recommends routine HIV screening for people aged 13-64 years in health-care settings, including sexually transmitted disease (STD) clinics, where the prevalence of previously undiagnosed HIV is $0.1%. These recommendations state that prevention counseling is strongly encouraged for people receiving HIV screening in STD clinics.…”

Coinfections of Human Immunodeficiency Virus and Sexually Transmitted Infections among HIV Seropositive Pregnant Women at Healthcare Centres in Akure, Southwestern Nigeria

“…Such co-infections may significantly increase HIV plasma viral load [6]. It was estimated that a 10-fold increase of plasma HIV RNA resulted in an 81% increased rate of HIV transmission [7,8]. About 350-400 million people worldwide are chronically infected with HBV, with over a million individuals dying annually from HBV related complications [2].…”

“…HIV and HBV are two viruses with similar modes of transmission through sexual contact, mother-to-child transmission (MTCT) in pregnancy, breast-feeding and intravenous drug use [2]. While HIV and HBV have common modes of transmission, HBV has been shown to be about 100 times more infectious [8]. Our study investigated the frequency of HIV-STI coinfections and their effects on CD4+ cell count, HIV plasma viral load and liver enzyme elevations in 50% of HIV seropositive subjects and 22.2% for seronegative controls.…”