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Viral Load Significant Factor in HIV-1 Transmission

MONDAY, Jan. 16 (HealthDay News) -- In serodiscordant couples, higher HIV-1 RNA levels in the infected partner significantly increase the risk of HIV-1 transmission, according to a study published online Jan. 11 in the Journal of Infectious Diseases.

James P. Hughes, Ph.D., from the University of Washington in Seattle, and colleagues analyzed data on HIV-1 infectivity, based on the number of sex acts and condom use, from 3,297 African HIV-1-serodiscordant couples.

The researchers found that there were 86 linked HIV-1 transmissions. The unadjusted per-unprotected act risk of HIV-1 transmission was 0.0019 for male-to-female transmission and 0.0010 for female-to-male transmission. The relative risk for male-to-female versus female-to-male transmission was 1.03 (P = 0.93), after adjusting for plasma HIV-1 RNA of the HIV-1-infected partner, and age and herpes simplex virus type 2 status of the uninfected partner. The per-act risk of HIV-1 transmission increased 2.9-fold for each log₁₀ increase in plasma HIV-1 RNA in the infected partner, while condom use decreased the per-act risk of transmission by 78 percent.

"Modifiable risk factors for HIV-1 transmission were plasma HIV-1 RNA level and condom use, and, in HIV-1-uninfected partners, herpes simplex virus 2 infection, genital ulcers, Trichomonas vaginalis, vaginitis or cervicitis, and male circumcision," the authors conclude.

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