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dc.contributor.authorNelson SewankamboSewankambo, K. Nelson Sewankambo
dc.date.accessioned2022-02-15T07:13:20Z
dc.date.available2022-02-15T07:13:20Z
dc.date.issued2000
dc.identifier.citationQuinn, T. C., Wawer, M. J., Sewankambo, N., Serwadda, D., Li, C., Wabwire-Mangen, F., ... & Gray, R. H. (2000). Viral load and heterosexual transmission of human immunodeficiency virus type 1. New England journal of medicine, 342(13), 921-929.en_US
dc.identifier.other10.1056/NEJM200003303421303
dc.identifier.urihttps://nru.uncst.go.ug/xmlui/handle/123456789/2112
dc.description.abstractBackground and Methods We examined the influence of viral load in relation to other risk factors for the heterosexual transmission of human immunodeficiency virus type 1 (HIV-1). In a community-based study of 15,127 persons in a rural district of Uganda, we identified 415 couples in which one partner was HIV-1–positive and one 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. Results The male partner was HIV-1–positive in 228 couples, and the female partner was HIV-1–positive in 187 couples. Ninety of the 415 initially HIV-1– negative partners seroconverted (incidence, 11.8 per 100 person-years). The rate of male-to-female transmission was not significantly different from the rate of female-to-male transmission (12.0 per 100 personyears vs. 11.6 per 100 person-years). The incidence of seroconversion was highest among the partners who were 15 to 19 years of age (15.3 per 100 person-years). The incidence was 16.7 per 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 RNA level was significantly higher among HIV-1–positive subjects whose partners seroconverted than among those whose partners did not seroconvert (90,254 copies per milliliter vs. 38,029 copies per milliliter, P=0.01). There were no instances of transmission among the 51 subjects with serum HIV-1 RNA levels of less than 1500 copies per milliliter; there was a significant dose– response relation of increased transmission with increasing viral load. In multivariate analyses of logtransformed HIV-1 RNA levels, each log increment in the viral load was associated with a rate ratio of 2.45 for seroconversion (95 percent confidence interval, 1.85 to 3.26). Conclusions 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 milliliter. (N Engl J Med 2000;342:921-9.) ©2000, Massachusetts Medical Society.en_US
dc.language.isoenen_US
dc.publisherNew England journal of medicineen_US
dc.subjectViral loaden_US
dc.subjectHeterosexual transmissionen_US
dc.subjectHuman immunodeficiency virus Type 1en_US
dc.titleViral load and heterosexual transmission of human immunodeficiency virus type 1en_US
dc.typeArticleen_US


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