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Genital HIV RNA Quantity Predicts HIV Transmission Risk

Last Updated: April 07, 2011.

Higher genital HIV-1 RNA concentrations are associated with greater risk of heterosexual HIV-1 transmission, independent of plasma HIV-1 quantity, according to a study published in the April 6 issue of Science Translational Medicine.

THURSDAY, April 7 (HealthDay News) -- Higher genital HIV-1 RNA concentrations are associated with greater risk of heterosexual HIV-1 transmission, independent of plasma HIV-1 quantity, according to a study published in the April 6 issue of Science Translational Medicine.

Jared M. Baeten, M.D., from the University of Washington in Seattle, and colleagues evaluated the quantity of genital HIV-1 RNA and the HIV-1 transmission risk. The study included 2,521 African HIV-1 serodiscordant couples. Serological testing was carried out on endocervical samples from 1,805 women, including 46 who transmitted HIV-1 to their partner, and on semen samples from 716 men, including 32 who transmitted HIV-1 to their partner.

The investigators found that genital and plasma HIV-1 RNA concentrations were correlated (Spearmans rank correlation coefficient, 0.56 and 0.55, for endocervical swabs and semen, respectively). Risk of HIV-1 transmission increased with each 1.0 log10 increase in genital HIV-1 RNA (2.20-fold for endocervical swabs and 1.79-fold for semen). Genital HIV-1 RNA predicted HIV-1 transmission risk independent of plasma HIV-1 quantity (hazard ratio, 1.67 for endocervical swabs and 1.68 for semen). There were 11 cases of HIV-1 transmission occurring from an individual with undetectable genital HIV-1 RNA and detectable plasma HIV-1 RNA (incidence less than 1 percent per year).

"Our data provide empirical evidence that differences in genital tract concentrations of HIV-1 RNA influence the transmission risk of HIV-1 infection, and we found that this relationship was independent of plasma HIV-1 concentrations," the authors write.

Two of the study authors disclosed financial relationships with the pharmaceutical industry.

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