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Abstract
The impact of ART on HIV transmission among HIV serodiscordant couples
K. Kayitenkore1, B. Bekan1, J. Rufagari1, S. Marion-Landais1, E. Karita1, S. Allen2, RZHRG
Background: Scaling-up of antiretroviral Treatment (ART) started in Kigali in the year 2003. Recent studies have shown that ART reduces sexual transmission of HIV-1. At Projet San Francisco (PSF) in Kigali, a case control study was conducted to assess the impact of that treatment on HIV-1 transmission within HIV discordant couples, and to confirm whether or not it is legitimate to forecast a meaningful reduction in HIV transmission based on provision of ART.
Methods: All infected individuals who had a CD4 count < 200cells/mL or/and a clinical stage III/IV (according to the WHO classification) were eligible for ART. We reviewed the clinical charts and analyzed the data of HIV discordant couples followed in Kigali. Self-reported condom use was adjusted for and included in the analysis.
Results: Of the 1034 couples followed at PSF, 248 have the HIV positive partner on ART. Only 2 (5%) of the 42 seroconversions observed since 2003 occurred in couples in which the positive partner was on ART. HIV negative individuals whose partners are on ART are less likely to seroconvert compared to those whose partners are not on ART, OR=0.19 (95% CI 0.05-0.80). After adjusting for the confounding effect of condom use, the result remains statistically significant with an OR of 0.21 (95% CI 0.05-0.89).
Conclusions: Our analysis confirms that the benefit of ART goes beyond the expected effect on disease progression and life prolongation, with a protective effect on the negative partners. The ongoing up-scaling of ART could result in a considerable decrease in HIV incidence in the population when part of a comprehensive effort for treatment and prevention.
However since most discordant couples have HIV+ partners who do not qualify for AR
AIDS 2006 - XVI International AIDS Conference
Abstract no.
MOKC101
Suggested Citation
"K.Kayitenkore, et al.
The impact of ART on HIV transmission among HIV serodiscordant couples.
Poster discussion:
AIDS 2006 - XVI International AIDS Conference:
Abstract no.
MOKC101"
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