Show simple item record

dc.contributor.authorLingappa, Jairam R.
dc.contributor.authorBaeten, Jared M.
dc.contributor.authorCelum, Connie
dc.contributor.authorGray, Glenda E.
dc.contributor.authorStevens, Wendy S.
dc.contributor.authorDonnell, Deborah
dc.contributor.authorFarquhar, Carey
dc.contributor.authorMullins, James I.
dc.contributor.authorCoombs, Robert W.
dc.contributor.authorRees, Helen
dc.contributor.authorCorey, Lawrence
dc.contributor.authorWald, Anna
dc.contributor.authorHughes, James P.
dc.contributor.authorWang, Richard S.
dc.contributor.authorCampbell, Mary S.
dc.contributor.authorEssex, Myron Elmer
dc.date.accessioned2013-04-01T17:36:49Z
dc.date.issued2010
dc.identifier.citationLingappa, Jairam R., James P. Hughes, Richard S. Wang, Jared M. Baeten, Connie Celum, Glenda E. Gray, Wendy S. Stevens, et al. 2010. Estimating the Impact of Plasma HIV-1 RNA Reductions on Heterosexual HIV-1 Transmission Risk. PLoS ONE 5(9): e12598.en_US
dc.identifier.issn1932-6203en_US
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:10482816
dc.description.abstractBackground: The risk of sexual transmission of HIV-1 is strongly associated with the level of HIV-1 RNA in plasma making reduction in HIV-1 plasma levels an important target for HIV-1 prevention interventions. A quantitative understanding of the relationship of plasma HIV-1 RNA and HIV-1 transmission risk could help predict the impact of candidate HIV-1 prevention interventions that operate by reducing plasma HIV-1 levels, such as antiretroviral therapy (ART), therapeutic vaccines, and other non-ART interventions. Methodology/Principal Findings: We use prospective data collected from 2004 to 2008 in East and Southern African HIV-1 serodiscordant couples to model the relationship of plasma HIV-1 RNA levels and heterosexual transmission risk with confirmation of HIV-1 transmission events by HIV-1 sequencing. The model is based on follow-up of 3381 HIV-1 serodiscordant couples over 5017 person-years encompassing 108 genetically-linked HIV-1 transmission events. HIV-1 transmission risk was 2.27 per 100 person-years with a log-linear relationship to log10 plasma HIV-1 RNA. The model predicts that a decrease in average plasma HIV-1 RNA of 0.74 log10 copies/mL (95% CI 0.60 to 0.97) reduces heterosexual transmission risk by 50%, regardless of the average starting plasma HIV-1 level in the population and independent of other HIV-1-related population characteristics. In a simulated population with a similar plasma HIV-1 RNA distribution the model estimates that 90% of overall HIV-1 infections averted by a 0.74 copies/mL reduction in plasma HIV-1 RNA could be achieved by targeting this reduction to the 58% of the cohort with plasma HIV-1 levels ≥4 log10 copies/mL. Conclusions/Significance: This log-linear model of plasma HIV-1 levels and risk of sexual HIV-1 transmission may help estimate the impact on HIV-1 transmission and infections averted from candidate interventions that reduce plasma HIV-1 RNA levels.en_US
dc.language.isoen_USen_US
dc.publisherPublic Library of Scienceen_US
dc.relation.isversionofdoi:10.1371/journal.pone.0012598en_US
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2938354/pdf/en_US
dash.licenseLAA
dc.subjectinfectious diseasesen_US
dc.subjectepidemiology and control of infectious diseasesen_US
dc.subjectHIV infection and AIDSen_US
dc.subjectsexually transmitted diseasesen_US
dc.titleEstimating the Impact of Plasma HIV-1 RNA Reductions on Heterosexual HIV-1 Transmission Risken_US
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden_US
dc.relation.journalPLoS ONEen_US
dash.depositing.authorEssex, Myron Elmer
dc.date.available2013-04-01T17:36:49Z
dash.affiliation.otherSPH^Immunology and Infectious Diseasesen_US
dc.identifier.doi10.1371/journal.pone.0012598*
dash.authorsorderedfalse
dash.contributor.affiliatedHughes, James P.
dash.contributor.affiliatedEssex, Myron


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record