Autor: |
Pamela M Murnane, James P Hughes, Connie Celum, Jairam R Lingappa, Nelly Mugo, Carey Farquhar, James Kiarie, Anna Wald, Jared M Baeten, Partners in Prevention HSV/HIV Transmission Study Team |
Jazyk: |
angličtina |
Rok vydání: |
2012 |
Předmět: |
|
Zdroj: |
PLoS ONE, Vol 7, Iss 11, p e51192 (2012) |
Druh dokumentu: |
article |
ISSN: |
1932-6203 |
DOI: |
10.1371/journal.pone.0051192 |
Popis: |
Current WHO guidelines recommend antiretroviral therapy (ART) initiation at CD4 counts ≤350 cells/µL. Increasing this threshold has been proposed, with a primary goal of reducing HIV-1 infectiousness. Because the quantity of HIV-1 in plasma is the primary predictor of HIV-1 transmission, consideration of plasma viral load in ART initiation guidelines is warranted.Using per-sex-act infectivity estimates and cross-sectional sexual behavior data from 2,484 HIV-1 infected persons with CD4 counts >350 enrolled in a study of African heterosexual HIV-1 serodiscordant couples, we calculated the number of transmissions expected and the number potentially averted under selected scenarios for ART initiation: i) CD4 count 350 while averting 40.5% of expected transmissions (ratio 2.0); treating at viral load ≥10,0000 copies/mL had a ratio of 1.5. In contrast, initiation at CD4 count |
Databáze: |
Directory of Open Access Journals |
Externí odkaz: |
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