Plasma and rectal viral load correlated in HIV-positive gay men: supports use of treatment as prevention

via European AIDS Treatment Group, by Michael Carter

Viral load in the blood and rectal secretions of HIV-positive gay men are highly correlated, according to US research published in the September 1st edition of the Journal of Infectious Diseases. The study also showed that the presence of sexually transmitted infections did not increase rectal viral load.

Individuals with a plasma viral load above 1000 copies/ml were significantly more likely to have detectable virus in the rectum.

“Our data add substantially to the few published studies of HIV shedding in rectal secretions of MSM [men who have sex with men],” comment the investigators, “we were able to quantify HIV RNA in rectal secretions, demonstrate the linear correlation between increasing plasma load and rectal viral load and determine a threshold plasma viral load that distinguished detectable from undetectable rectal viral load.”

They also believe that their findings have important implications for current debates about the use of HIV treatment as prevention, commenting: “Combination antiretroviral therapy will have a similar effect on reducing HIV transmission in MSM, as seen in studies of heterosexual discordant couples.”

Read the rest.


[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]

Is treatment really reducing infections?

via Aidsmap, by Gus Cairns

Moupali Das of the San Francisco Department of Public Health presented evidence to show that the city’s intensive testing and treatment policy was beginning to result in a declining HIV infection rate there. Similar evidence was presented from the province of British Columbia in Canada.

The evidence presented still leaves some questions unanswered, however.

• Is the reduction in viral load in the HIV-positive population (the 'community viral load' or CVL) really the cause of the decreased level of diagnoses seen in San Francisco in the last few years, or is it due to the success of prevention campaigns and reductions in risky behaviour?
  
• Do reduced diagnoses really indicate reduced incidence of infection?
  
• Is reducing the average viral load of diagnosed people a good indicator of the average infectiousness of people with HIV in the community – or do high viral loads in the minority who remain undiagnosed make this an unreliable indicator?

The answers to these questions are crucial as the future direction of HIV prevention policy may depend on them, in particular whether to concentrate on suppressing viral load or on behaviour change as the mainspring of prevention.

Read the rest. 

[If an item is not written by an IRMA member, it should not be construed that IRMA has taken a position on the article's content, whether in support or in opposition.]