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A recent review indicated that
heterosexual serodiscordant couples have a low risk of HIV transmission if the
HIV-infected partner has an undetectable viral load as a result of successful
antiretroviral (ARV) therapy. The study by the National AIDS Treatment Advocacy
Policy was presented at the Third International Workshop on HIV and Women in
Toronto, Canada.
Researchers combined data from six
studies of serodiscordant heterosexual couples. Three studies provided data on
HIV transmission rates, ARV history, and viral load of the HIV-infected
partner. These studies included 991 couples with 2,064 person-years of
follow-up. The researchers found a 0.0 per 100 person-years transmission rate.
The other three studies included rates of transmission and treatment history of
5,233 couples. When these three studies were combined with the previous three,
the researchers found a pooled transmission risk of 0.14 per 100 person-years.
This means that if 1,000 serodiscordant couples in which the HIV-infected
partner is on ARV therapy with an undetectable viral load had sex for one year,
approximately one or two non-infected partners would become infected with HIV.
In the six studies, the four
transmissions took place before the HIV-infected partner had been on ARVs for
six months; therefore, the seropositive partner may not have reached an
undetectable viral load by that point. The researchers performed another
analysis excluding the data from these transmissions. The result of this second
analysis was a transmission risk of 0.0 per 100 person-years.
Sten H. Vermund, MD., Ph.D.,
director of the Institute for Global Health at Tennessee’s Vanderbilt
University, warned that individuals who have what appears to be an undetectable
viral load may have what he calls, “viral spikes,” which may intermittently put
a partner at risk of HIV infection. He advised that to have a zero risk of
transmitting the virus to others, individuals should “be on antiretrovirals
religiously and also use condoms.”
The conference abstract is available
at http://www.natap.org/2013/HIVwomen/HIVwomen_01.htm.
The Friends of AIDS Foundation is
dedicated to enhancing the quality of life for HIV positive individuals and
empowering people to make healthy choices to prevent the spread of the HIV
virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.
TOGETHER WE REMAIN STRONG!
