title: High proportion of HIV serodiscordance among HIV-affected married couples in northern Vietnam.
abstract: BACKGROUND
  Little is known about the state of HIV transmission among married couples in Vietnam. This study aims to clarify HIV serostatus in this group and elucidate risk factors for intra-marital HIV transmission.
  
  
  METHODS
  In 2012, we enrolled a group of HIV-positive married men registered at the HIV outpatient clinic of a referral hospital in northern Vietnam, along with their wives. Sociodemographic, behavioural and clinical data were collected from men and wives. HIV serodiscordant couples were followed until March 2014 to determine seroconversion rate. A phylogenetic analysis was performed based on env V3 sequence to detail cluster formation among men.
  
  
  RESULTS
  Of the 163 HIV-positive men enrolled in the study, 101 (62.0%) had wives testing HIV-negative. Half of men reported injecting drug use (IDU) as a likely transmission route. Couples reported a high incidence of unprotected sexual intercourse prior to diagnosis; the median (inter quartile range) was 4 (4-8) times per month. Only 17 couples (10.4%) reported using condoms during at least half these instances. Multivariable analysis revealed IDU history among men was independently associated with HIV-negative wives (adjusted OR 0.31; 95% CI 0.10-0.95, p=0.041). Phylogenetic analysis of 80 samples indicated CRF01_AE. Of these, 69 (86.3%) clustered with IDU-associated viruses from Vietnam. No HIV seroconversion was identified during a follow-up of 61 serodiscordant couples, with 126.5 person-years of observation during which HIV-infected men were on antiretroviral drug therapy (ART).
  
  
  CONCLUSIONS
  High HIV serodiscordance was observed among HIV-affected married couples in northern Vietnam. A large number of at-risk wives therefore remain HIV-negative and can be protected with measures including proper use of ART if couples are made aware of the serodiscordance through screening.
authors.affiliation: Department of Clinical Tropical Medicine, Institute of Tropical Medicine, Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan; AIDS Clinical Center, National Center of Global Health and Medicine, Tokyo, Japan.
authors.forename: Ikumi
authors.initials: I
authors.lastname: Sawada
authors.affiliation: AIDS Clinical Center, National Center of Global Health and Medicine, Tokyo, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Tanuma
authors.affiliation: Department of Infectious Diseases, Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Cuong Duy
authors.initials: CD
authors.lastname: Do
authors.affiliation: Department of Infectious Diseases, Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Tra Thu
authors.initials: TT
authors.lastname: Doan
authors.affiliation: Laboratory for Molecular Diagnostics, Department of Immunology and Molecular Biology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
authors.forename: Quynh Phuong
authors.initials: QP
authors.lastname: Luu
authors.affiliation: Laboratory for Molecular Diagnostics, Department of Immunology and Molecular Biology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
authors.forename: Lan Anh Thi
authors.initials: LA
authors.lastname: Nguyen
authors.affiliation: Microbiology Department, Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Tuong Van Thi
authors.initials: TV
authors.lastname: Vu
authors.affiliation: Department of Infectious Diseases, Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Tuan Quang
authors.initials: TQ
authors.lastname: Nguyen
authors.affiliation: Department of Clinical Tropical Medicine, Institute of Tropical Medicine, Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan.
authors.forename: Naho
authors.initials: N
authors.lastname: Tsuchiya
authors.affiliation: Infectious Diseases Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan.
authors.forename: Teiichiro
authors.initials: T
authors.lastname: Shiino
authors.affiliation: Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan.
authors.forename: Lay-Myint
authors.initials: LM
authors.lastname: Yoshida
authors.affiliation: Department of Infectious Diseases, Bach Mai Hospital, Hanoi, Vietnam.
authors.forename: Thanh Thuy Thi
authors.initials: TT
authors.lastname: Pham
authors.affiliation: Department of Clinical Tropical Medicine, Institute of Tropical Medicine, Graduate School of Biomedical Science, Nagasaki University, Nagasaki, Japan.
authors.forename: Koya
authors.initials: K
authors.lastname: Ariyoshi
authors.affiliation: AIDS Clinical Center, National Center of Global Health and Medicine, Tokyo, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Oka
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D017280:Condoms / Q000706:statistics & numerical data*; D005191:Family Characteristics; D005260:Female; D005838:Genotype; D006679:HIV Seropositivity / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D015497:HIV-1 / Q000145:classification / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008393:Marriage; D010045:Outpatients; D010802:Phylogeny; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D014744:Vietnam / Q000453:epidemiology; D054299:env Gene Products, Human Immunodeficiency Virus / Q000235:genetics
chemical_list: D054299:env Gene Products, Human Immunodeficiency Virus