Academic journal article Bulletin of the World Health Organization

Viral Load Best Predictor of HIV Transmission

Academic journal article Bulletin of the World Health Organization

Viral Load Best Predictor of HIV Transmission

Article excerpt

The higher the concentration of human immunodeficiency virus type 1 (HIV-1) in the bloodstream, the greater the risk of transmitting the virus to a partner during heterosexual intercourse, a large study conducted in sub-Saharan Africa has found. The number of copies of HIV-1 ribonucleic acid (RNA) in the blood, an indicator of viral load, was a better predictor of whether transmission would occur than many other factors, such as the presence of other sexually transmitted diseases (New England Journal of Medicine, 2000, 342: 921-929).

Thomas C. Quinn, Professor of Medicine at Johns Hopkins University in Baltimore, MD, said the study found a clear dose--response relationship between viral load and transmission. "For every 10-fold rise in the concentration of HIV in the bloodstream, transmission more than doubled," he said.

Conducted in the Rakai district of Uganda by researchers from the United States and Uganda, the project involved following 415 couples where only one partner was HIV-positive. All participants received free condoms, voluntary confidential HIV testing and counselling, as well as health education directed at preventing HIV transmission. Researchers visited the couples at 10-month intervals for up to 30 months. At each visit, the participants gave blood samples and these were later tested to determine HIV viral load. Over the period of the study, 90 (22%) of the previously uninfected partners became HIV-positive. Analysis of the blood tests showed that in nearly 80% of these cases, the viral load of the infected partner was above 10 000 copies of HIV-1 RNA/ml of blood. No one who had fewer than 1500 copies of HIV-1 RNA/ml of blood transmitted the virus to his or her partner. …

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