24 August 2009
Sexual transmission of HIV according to viral load and antiretroviral therapy: systematic review and meta-analysis.
Attia S, Egger M, Müller M et al.
AIDS 2009;23:1397–404.
• This meta-analysis assessed the risk of HIV transmission through unprotected sexual intercourse according to VL and ART by reviewing Medline, Embase and conference abstracts from 1996–2009 for longitudinal studies of serodiscordant couples reporting HIV transmission according to plasma VL or use of ART.
• The overall rate of transmission from ART-treated patients was 0.46 (95% CI: 0.19–1.09) per 100 person-years, based on five events.
• The transmission rate from a seropositive partner with VL <400 copies/mL on ART, based on two studies, was zero (upper 97.5% CI: 1.27 per 100 person-years) and 0.16 (95% CI: 0.02–1.13) per 100 person-years if not on ART, based on five studies and one event.
• Conclusion: Studies of heterosexual discordant couples observed no transmission in patients treated with ART and with VL <400 copies/mL, but data were compatible with one transmission per 79 person-years.
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24 August 2009
Data are lacking for quantifying HIV transmission risk in the presence of effective antiretroviral therapy.
Wilson DP.
AIDS 2009;23:1431–3.
• This meta-analysis assessed the risk of HIV transmission through unprotected sexual intercourse according to VL and ART by reviewing Medline, Embase and conference abstracts from 1996–2009 for longitudinal studies of serodiscordant couples reporting HIV transmission according to plasma VL or use of ART.
• The overall rate of transmission from ART-treated patients was 0.46 (95% CI: 0.19–1.09) per 100 person-years, based on five events.
• The transmission rate from a seropositive partner with VL <400 copies/mL on ART, based on two studies, was zero (upper 97.5% CI: 1.27 per 100 person-years) and 0.16 (95% CI: 0.02–1.13) per 100 person-years if not on ART, based on five studies and one event.
• Conclusion: Studies of heterosexual discordant couples observed no transmission in patients treated with ART and with VL <400 copies/mL, but data were compatible with one transmission per 79 person-years.
Link
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