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CiteWeb id: 20090000234

CiteWeb score: 2824

DOI: 10.1056/NEJM200003303421303

The authors examined the influence of viral load in relation to other risk factors for the heterosexual transmission of HIV type 1 (HIV-1). In a community-based study of 15127 persons in a rural district of Uganda the authors identified 415 couples in which 1 partner was HIV-1-positive and 1 was initially HIV-1-negative and followed them prospectively for up to 30 months. The incidence of HIV-1 infection per 100 person-years among the initially seronegative partners was examined in relation to behavioral and biologic variables. The male partner was HIV-1-positive in 228 couples and the female partner was HIV-1-positive in 187 couples. 90 of the 415 initially HIV-1-negative partners seroconverted (incidence 11.8/100 person-years). The rate of male-to-female transmission was not significantly different from the rate of female-to-male transmission (12.0/100 person-years vs. 11.6/100 person-years). The incidence of seroconversion was highest among the partners who were aged 15-19 years (15.3/100 person-years). The incidence was 16.7/100 person-years among 137 uncircumcised male partners whereas there were no seroconversions among the 50 circumcised male partners (P < 0.001). The mean serum HIV-1 ribonucleic acid (RNA) level was significantly higher among HIV-1-positive subjects whose partners seroconverted than among those whose partners did not seroconvert (90254 copies/ml vs. 38029 copies/ml; P = 0.01). There were no instances of transmission among the 51 subjects with serum HIV-1 RNA levels of less than 1500 copies/ml; there was a significant dose response relation of increased transmission with increasing viral load. In multivariate analyses of log-transformed HIV-1 RNA levels each log increment in the viral load was associated with a rate ratio of 2.45 for seroconversion (95% confidence interval 1.85-3.26). The viral load is the chief predictor of the risk of heterosexual transmission of HIV-1 and transmission is rare among persons with levels of less than 1500 copies of HIV-1 RNA per ml. (authors)

The publication "VIRAL LOAD AND HETEROSEXUAL TRANSMISSION OF HUMAN IMMUNODEFICIENCY VIRUS TYPE 1" is placed in the Top 10000 of the best publications in CiteWeb. Also in the category Medicine it is included to the Top 1000. Additionally, the publicaiton "VIRAL LOAD AND HETEROSEXUAL TRANSMISSION OF HUMAN IMMUNODEFICIENCY VIRUS TYPE 1" is placed in the Top 1000 among other scientific works published in 2009.
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