title: Heterosexual HIV-1 transmission and viral load in hemophilic patients.
abstract: Only one fifth or fewer of the female sexual partners of HIV-1-infected men with hemophilia become infected. The risk factors associated with heterosexual transmission of HIV-1 are not well understood. To investigate the hypothesis that HIV-1 viral load may be related to heterosexual HIV-1 transmission, we measured HIV-1 RNA by polymerase chain reaction (PCR) in frozen samples from 39 men with hemophilia and HIV-1 infection obtained between 20 and 62 months after HIV-1 seroconversion, during at least a 6-month relationship with a female sexual partner. The median time from the hemophilic viral load determination to the estimated date of transmission to the female partner was 9 months (range, 4-41 months). The proportion of HIV-positive hemophilic men with >100,000 HIV RNA copies/ml was significantly higher in transmitters (TR) (3 of 5 [60%]), than in nontransmitters (NTR) (3 of 34 [9%]; p = 0.027). There were no differences between TR and NTR in age at seroconversion (32.4 years each), in time from seroconversion to AIDS (67 versus 79 months), in mean CD4 number (245/microl] versus 260/microl); nor in the proportion who developed AIDS (4 of 5 [80%] versus 24 of 34 [71%]). These findings appear to suggest that high HIV viral load in HIV-infected hemophilic men increases the risk of HIV transmission to heterosexual partners. Viral load determinations may be helpful in counseling hemophilic couples regarding transmission to female partners.
authors.affiliation: Department of Medicine, University of Pittsburgh School of Medicine and The Hemophilia Center of Western Pennsylvania, 15213-4306, USA.
authors.forename: M V
authors.initials: MV
authors.lastname: Ragni
authors.forename: H
authors.initials: H
authors.lastname: Faruki
authors.forename: L A
authors.initials: LA
authors.lastname: Kingsley
mesh_terms: D018562:Disease Transmission, Infectious; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000635:transmission*; D015497:HIV-1; D006467:Hemophilia A / Q000150:complications / Q000821:virology*; D020010:Heterosexuality; D006801:Humans; D008297:Male; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000097:blood; D012307:Risk Factors; D019562:Viral Load
chemical_list: D012367:RNA, Viral