Determinants of per-coital-act HIV-1 infectivity among African HIV-1-serodiscordant couples
Knowledge of factors that affect per-act infectivity of human immunodeficiency virus type 1 (HIV-1) is important for designing HIV-1 prevention interventions and for the mathematical modeling of the spread of HIV-1. We analyzed data from a prospective study of African HIV-1-serodiscordant couples. W...
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| Vydáno v: | The Journal of infectious diseases Ročník 205; číslo 3; s. 358 |
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| Hlavní autoři: | , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | angličtina |
| Vydáno: |
United States
01.02.2012
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| Témata: | |
| ISSN: | 1537-6613, 1537-6613 |
| On-line přístup: | Zjistit podrobnosti o přístupu |
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| Abstract | Knowledge of factors that affect per-act infectivity of human immunodeficiency virus type 1 (HIV-1) is important for designing HIV-1 prevention interventions and for the mathematical modeling of the spread of HIV-1.
We analyzed data from a prospective study of African HIV-1-serodiscordant couples. We assessed transmissions for linkage within the study partnership, based on HIV-1 sequencing. The primary exposure measure was the HIV-1-seropositive partners' reports of number of sex acts and condom use with their study partner.
Of 3297 couples experiencing 86 linked HIV-1 transmissions, the unadjusted per-act risks of unprotected male-to-female (MTF) and female-to-male (FTM) transmission were 0.0019 (95% confidence interval [CI], .0010-.0037) and 0.0010 (95% CI, .00060-.0017), respectively. After adjusting for plasma HIV-1 RNA of the HIV-1-infected partner and herpes simplex virus type 2 serostatus and age of the HIV-1-uninfected partner, we calculated the relative risk (RR) for MTF versus FTM transmission to be 1.03 (P = .93). Each log(10) increase in plasma HIV-1 RNA increased the per-act risk of transmission by 2.9-fold (95% CI, 2.2-3.8). Self-reported condom use reduced the per-act risk by 78% (RR = 0.22 [95% CI, .11-.42]).
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. |
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| AbstractList | Knowledge of factors that affect per-act infectivity of human immunodeficiency virus type 1 (HIV-1) is important for designing HIV-1 prevention interventions and for the mathematical modeling of the spread of HIV-1.
We analyzed data from a prospective study of African HIV-1-serodiscordant couples. We assessed transmissions for linkage within the study partnership, based on HIV-1 sequencing. The primary exposure measure was the HIV-1-seropositive partners' reports of number of sex acts and condom use with their study partner.
Of 3297 couples experiencing 86 linked HIV-1 transmissions, the unadjusted per-act risks of unprotected male-to-female (MTF) and female-to-male (FTM) transmission were 0.0019 (95% confidence interval [CI], .0010-.0037) and 0.0010 (95% CI, .00060-.0017), respectively. After adjusting for plasma HIV-1 RNA of the HIV-1-infected partner and herpes simplex virus type 2 serostatus and age of the HIV-1-uninfected partner, we calculated the relative risk (RR) for MTF versus FTM transmission to be 1.03 (P = .93). Each log(10) increase in plasma HIV-1 RNA increased the per-act risk of transmission by 2.9-fold (95% CI, 2.2-3.8). Self-reported condom use reduced the per-act risk by 78% (RR = 0.22 [95% CI, .11-.42]).
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. Knowledge of factors that affect per-act infectivity of human immunodeficiency virus type 1 (HIV-1) is important for designing HIV-1 prevention interventions and for the mathematical modeling of the spread of HIV-1.BACKGROUNDKnowledge of factors that affect per-act infectivity of human immunodeficiency virus type 1 (HIV-1) is important for designing HIV-1 prevention interventions and for the mathematical modeling of the spread of HIV-1.We analyzed data from a prospective study of African HIV-1-serodiscordant couples. We assessed transmissions for linkage within the study partnership, based on HIV-1 sequencing. The primary exposure measure was the HIV-1-seropositive partners' reports of number of sex acts and condom use with their study partner.METHODSWe analyzed data from a prospective study of African HIV-1-serodiscordant couples. We assessed transmissions for linkage within the study partnership, based on HIV-1 sequencing. The primary exposure measure was the HIV-1-seropositive partners' reports of number of sex acts and condom use with their study partner.Of 3297 couples experiencing 86 linked HIV-1 transmissions, the unadjusted per-act risks of unprotected male-to-female (MTF) and female-to-male (FTM) transmission were 0.0019 (95% confidence interval [CI], .0010-.0037) and 0.0010 (95% CI, .00060-.0017), respectively. After adjusting for plasma HIV-1 RNA of the HIV-1-infected partner and herpes simplex virus type 2 serostatus and age of the HIV-1-uninfected partner, we calculated the relative risk (RR) for MTF versus FTM transmission to be 1.03 (P = .93). Each log(10) increase in plasma HIV-1 RNA increased the per-act risk of transmission by 2.9-fold (95% CI, 2.2-3.8). Self-reported condom use reduced the per-act risk by 78% (RR = 0.22 [95% CI, .11-.42]).RESULTSOf 3297 couples experiencing 86 linked HIV-1 transmissions, the unadjusted per-act risks of unprotected male-to-female (MTF) and female-to-male (FTM) transmission were 0.0019 (95% confidence interval [CI], .0010-.0037) and 0.0010 (95% CI, .00060-.0017), respectively. After adjusting for plasma HIV-1 RNA of the HIV-1-infected partner and herpes simplex virus type 2 serostatus and age of the HIV-1-uninfected partner, we calculated the relative risk (RR) for MTF versus FTM transmission to be 1.03 (P = .93). Each log(10) increase in plasma HIV-1 RNA increased the per-act risk of transmission by 2.9-fold (95% CI, 2.2-3.8). Self-reported condom use reduced the per-act risk by 78% (RR = 0.22 [95% CI, .11-.42]).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.CONCLUSIONSModifiable 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. |
| Author | Farquhar, Carey Magaret, Amalia S Celum, Connie Kiarie, James Lingappa, Jairam R Kilembe, William Baeten, Jared M Inambao, Mubiana de Bruyn, Guy Hughes, James P Wald, Anna |
| Author_xml | – sequence: 1 givenname: James P surname: Hughes fullname: Hughes, James P email: jphughes@u.washington.edu organization: Department of Biostatistics, University of Washington, Seattle 98195-7232, USA. jphughes@u.washington.edu – sequence: 2 givenname: Jared M surname: Baeten fullname: Baeten, Jared M – sequence: 3 givenname: Jairam R surname: Lingappa fullname: Lingappa, Jairam R – sequence: 4 givenname: Amalia S surname: Magaret fullname: Magaret, Amalia S – sequence: 5 givenname: Anna surname: Wald fullname: Wald, Anna – sequence: 6 givenname: Guy surname: de Bruyn fullname: de Bruyn, Guy – sequence: 7 givenname: James surname: Kiarie fullname: Kiarie, James – sequence: 8 givenname: Mubiana surname: Inambao fullname: Inambao, Mubiana – sequence: 9 givenname: William surname: Kilembe fullname: Kilembe, William – sequence: 10 givenname: Carey surname: Farquhar fullname: Farquhar, Carey – sequence: 11 givenname: Connie surname: Celum fullname: Celum, Connie |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/22241800$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Contributor | Coetzee, David Were, Edwin Kapiga, Saidi Cohen, Craig Manongi, Rachel Bukusi, Elizabeth Fife, Kenneth Allen, Susan Inambao, Mubiana Ronald, Allan Kayitenkore, Kayitesi Gray, Glenda Karita, Etienne Farquhar, Carey Katabira, Elly Makhema, Joseph Kiarie, James Delany-Moretlwe, Sinead Rees, Helen McIntyre, James John-Stewart, Grace Kanweka, William Essex, Max Vwalika, Bellington |
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| References | 20089951 - N Engl J Med. 2010 Feb 4;362(5):427-39 16327322 - AIDS. 2006 Jan 2;20(1):73-83 15809897 - J Infect Dis. 2005 May 1;191(9):1403-9 11461676 - AIDS Res Hum Retroviruses. 2001 Jul 1;17(10):901-10 20537376 - Lancet. 2010 Jun 12;375(9731):2092-8 21633287 - AIDS. 2011 Aug 24;25(13):1559-73 11869658 - Cochrane Database Syst Rev. 2002;(1):CD003255 20153888 - Lancet. 2010 Mar 6;375(9717):824-33 21399681 - PLoS One. 2011;6(3):e16986 21272789 - Lancet Infect Dis. 2011 Feb;11(2):81 22241799 - J Infect Dis. 2012 Feb 1;205(3):351-2 19404392 - PLoS One. 2009;4(4):e5272 11323041 - Lancet. 2001 Apr 14;357(9263):1149-53 11756980 - J Infect Dis. 2002 Jan 1;185(1):45-52 2085629 - Biometrics. 1990 Dec;46(4):1133-50 19179227 - Lancet Infect Dis. 2009 Feb;9(2):118-29 8601226 - J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Apr 1;11(4):388-95 9418153 - J Biol Regul Homeost Agents. 1997 Jan-Jun;11(1-2):3-6 18684670 - Lancet Infect Dis. 2008 Sep;8(9):553-63 21767103 - N Engl J Med. 2011 Aug 11;365(6):493-505 |
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| Title | Determinants of per-coital-act HIV-1 infectivity among African HIV-1-serodiscordant couples |
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