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Abstract
Demographic characteristics, sexual transmission and CD4 progression among heterosexual HIV-1 serodiscordant couples followed in Porto Alegre, Brazil
M. Melo1, I. Varella1, R. Lira1, K. Nielsen2, M. Turella1, B.R. Santos3
Background: We established a cohort of heterosexual HIV serodiscordant couples in a large urban HIV referral center. Data from 93 couples from February 2000 to January 2006 was analyzed regarding demographics, seroconversion of the non-infected partner, sexually transmitted diseases (STDs) and rate of CD4 decline.
Methods: A review of 4500 records revealed 56 cases of untreated index cases among serodiscordant couples. Thirty seven couples were identified prospectively. Medical history, physical exam, and laboratory testing were conducted.
Results: Ninety three HIV-1 serodiscordant couples with no ARV use were enrolled. Sixty seven (72%) index cases were female (49% identified during ante-natal care). Unprotected sexual intercourse as a risk factor for HIV-1 infection was significantly higher as compared to intravenous drug use (P <0.0001) in female index partners. Among male index cases, there was no difference. During follow up, 41/ 93 index cases (44%) used ARV. STDs were identified in 22 cases (24%). Six seroconversions occurred, and in all, index partners were not using ARV. Among 26 couples with a male index case, there were 4 seroconversions (15%) and among 67 female index cases there were 2 (3%). All seroconversions occurred with virus loads >1000 copies. Mean CD4 at the moment of seroconversion was 357.3 cells/mL. Eight female index cases (22%) and no male index cases reported no condom use. Fifteen of 49 index cases (31%) reached £300 CD4 cells over time. Mean time to achieve a CD4 of £300 cells/mL was 66 months. Patients with an initial CD4 >500 cells/mL, took a greater time to reach CD4 £300 cells/mL (mean 74 months), than those with initial CD4 £500 cells/mL, (mean 38 months).
Conclusions: Heterosexual transmission occurred more frequently from HIV-infected males to females. HIV transmission appeared to occur as a function of viral load. ARV use may play a role in the prevention of HIV-1 heterosexual transmission.
AIDS 2006 - XVI International AIDS Conference
Abstract no.
TUPE0430
Suggested Citation
"M.Melo, et al.
Demographic characteristics, sexual transmission and CD4 progression among heterosexual HIV-1 serodiscordant couples followed in Porto Alegre, Brazil.
:
AIDS 2006 - XVI International AIDS Conference:
Abstract no.
TUPE0430"
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