Health
The risk of sexually transmitting HIV from people on ART with low viral levels is almost zero
HIV infection is a continuing concern for people with detectable low levels of the virus, even if they are taking it. Antiretroviral therapy (ART). However, new An analysis of the study found that people in this category adhered to their behavior. ART carries almost zero risk of passing it on to sexual partners.
“These new findings are important because they show that the risk of sexual transmission of HIV when viral load is low is almost zero,” said study co-author Dr. Lara Vozinov in a statement. “This represents a powerful opportunity to destigmatize HIV, promote the benefits of adherence to antiretroviral therapy, and support people living with HIV.”
The research results are lancet. This research International AIDS Society Conference on HIV Science (IAS 2023).
The authors pointed out the associated risks and uncertainties in the medical community when a person is infected with a viral load >200 copies per mL.
“While HIV viral loads below 200 copies per mL are generally accepted as having zero risk of sexual transmission, and this threshold is used for U=U messaging in many high-income settings, the risk at viral levels above 200 copies per mL is controversial,” the researchers wrote.
Against this background, the researchers conducted a systematic review, searching PubMed, MEDLINE, The Cochrane Central Controlled Trials Registry, Embase, Conference Proceedings Citation Index-Science, and WHO Global Index Medicus during the publication period from 1 January 2010 to 17 November 2022.
They analyzed eight studies that examined people on ART in more than 7700 couples with low detectable levels of HIV, seromismatched, and one partner with HIV.
Of the 323 sexually transmitted HIV infections detected in all eight studies, only two involved partners with viral loads less than 1000 copies/mL, the authors note. In both cases, viral load testing was performed at least 50 days prior to infection, suggesting that individuals may have had elevated viral loads during the post-test period. In studies that provided the full range of viral loads in HIV-infected individuals, at least 80% of infections involved her viral load >10,000 copies/mL.
Simplified testing
On another important note, this may require scaling up testing so that more people can participate in continuing HIV treatment and initiating ART therapy for those who need it.
Laboratory-based plasma sample methods provide the most sensitive viral load test results, but such tests are not feasible in many parts of the world. However, new findings support the greater use of simpler testing approaches, such as using dried blood stain samples, as they are effective in classifying viral load for necessary clinical decisions.
“Importantly, this conclusion can facilitate the expansion of more feasible alternative viral load testing methods in resource-limited settings. Improving access to routine viral load testing may ultimately help people living with HIV live healthier lives and reduce viral transmission,” the authors concluded.
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