OA01-06 LB. HIV-1 plasma RNA and risk of HIV-1 transmission
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BioMed Central Page 1 of 1 (page number not for citation purposes) Retrovirology Open Access Oral presentation OA01-06 LB. HIV-1 plasma RNA and risk of HIV-1 transmission JR Lingappa* 1 , JP Hughes 1 , D Donnel 2 , JM Baeten 1 , JI Mullins 1 , MS Campbell 1 , GE Gray 3 , M Essex 4 , C Farquhar 1 , H Rees 3 , A Wald 1 , L Corey 1 and C Celum 1 Address: 1 University of Washington, Seattle, Washington, USA, 2 Fred Hutchinson Cancer Research Centre, Seattle, USA, 3 University of the Witwatersrand, Johannesburg, South Africa and 4 Harvard University, Boston, USA * Corresponding author Background Non-sterilizing HIV-1 vaccines may provide public health benefits if they significantly reduce plasma HIV-1 RNA, thus potentially reducing infectiousness. Quantification of reduction in plasma HIV-1 RNA needed to decrease HIV-1 transmission is useful for design of efficacy trials of candidate HIV-1 vaccines. We modeled the relationship between plasma HIV-1 RNA and HIV-1 transmission using data from a prospective study of African heterosex- ual HIV-1 serodiscordant couples. Methods 3408 HIV-1-infected participants with CD4 counts ≥250 cells/mm3 enrolled in the Partners in Prevention HSV/ HIV Transmission Study and their partners were followed for ≤24 months. HIV-1 transmission events were assessed for viral genetic linkage within the enrolled partnership by determining HIV-1 env and gag sequences from partners. The relationship between plasma HIV-1 RNA over time and risk of genetically linked HIV-1 transmission was evaluated with a Cox model with a natural cubic spline. Results 84 post-enrollment linked HIV-1 transmissions were observed. HIV-1 incidence increased rapidly and non-lin- early with higher plasma HIV-1: from 0.53 transmissions per 100 person-years for plasma HIV-1 RNA <10,000 cop- ies/mL to 6.2 for HIV-1 RNA >1,000,000 copies/mL (p<0.0001). Baseline HIV-1 RNA in men was, on average, 0.4 log10 higher than in women; no significant difference in risk of transmission for a given HIV-1 level was observed between men and women (p = 0.17). Given the distribution of plasma HIV-1 RNA in this population of stable cohabiting couples, our modeling predicts that a 0.74 log10 reduction in average plasma HIV-1 RNA in the population would be required for a 50% reduction in HIV-1 transmission risk. Conclusion This analysis provides a detailed description of the rela- tionship between plasma HIV-1 RNA and risk of hetero- sexual HIV-1 transmission. These findings suggest targets for reduction in HIV-1 RNA for use in evaluating non-ster- ilizing HIV-1 vaccine candidates in HIV-1 infected persons to reduce risk of heterosexual HIV-1 transmission. from AIDS Vaccine 2009 Paris, France. 19–22 October 2009 Published: 22 October 2009 Retrovirology 2009, 6(Suppl 3):O12 doi:10.1186/1742-4690-6-S3-O12 <supplement> <title> <p>AIDS Vaccine 2009</p> </title> <editor>Anna Laura Ross</editor> <note>Meeting abstracts – A single PDF containing all abstracts in this Supplement is available <a href="http://www.biomedcentral.com/content/files/pdf/1742-4690-6-S3-full.pdf">here</a>.</note> <url>http://www.biomedcentral.com/content/pdf/1471-2105-10-S12-info.pdf</url> </supplement> This abstract is available from: http://www.retrovirology.com/content/6/S3/O12 © 2009 BioMed Central Ltd.
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Transcript of OA01-06 LB. HIV-1 plasma RNA and risk of HIV-1 transmission
BioMed Central
Page 1 of 1(page number not for citation purposes)
Retrovirology
Open AccessOral presentationOA01-06 LB. HIV-1 plasma RNA and risk of HIV-1 transmissionJR Lingappa*1, JP Hughes1, D Donnel2, JM Baeten1, JI Mullins1, MS Campbell1, GE Gray3, M Essex4, C Farquhar1, H Rees3, A Wald1, L Corey1 and C Celum1
Address: 1University of Washington, Seattle, Washington, USA, 2Fred Hutchinson Cancer Research Centre, Seattle, USA, 3University of the Witwatersrand, Johannesburg, South Africa and 4Harvard University, Boston, USA
* Corresponding author
BackgroundNon-sterilizing HIV-1 vaccines may provide public healthbenefits if they significantly reduce plasma HIV-1 RNA,thus potentially reducing infectiousness. Quantificationof reduction in plasma HIV-1 RNA needed to decreaseHIV-1 transmission is useful for design of efficacy trials ofcandidate HIV-1 vaccines. We modeled the relationshipbetween plasma HIV-1 RNA and HIV-1 transmissionusing data from a prospective study of African heterosex-ual HIV-1 serodiscordant couples.
Methods3408 HIV-1-infected participants with CD4 counts ≥250cells/mm3 enrolled in the Partners in Prevention HSV/HIV Transmission Study and their partners were followedfor ≤24 months. HIV-1 transmission events were assessedfor viral genetic linkage within the enrolled partnership bydetermining HIV-1 env and gag sequences from partners.The relationship between plasma HIV-1 RNA over timeand risk of genetically linked HIV-1 transmission wasevaluated with a Cox model with a natural cubic spline.
Results84 post-enrollment linked HIV-1 transmissions wereobserved. HIV-1 incidence increased rapidly and non-lin-early with higher plasma HIV-1: from 0.53 transmissionsper 100 person-years for plasma HIV-1 RNA <10,000 cop-ies/mL to 6.2 for HIV-1 RNA >1,000,000 copies/mL(p<0.0001). Baseline HIV-1 RNA in men was, on average,
0.4 log10 higher than in women; no significant differencein risk of transmission for a given HIV-1 level wasobserved between men and women (p = 0.17). Given thedistribution of plasma HIV-1 RNA in this population ofstable cohabiting couples, our modeling predicts that a0.74 log10 reduction in average plasma HIV-1 RNA in thepopulation would be required for a 50% reduction inHIV-1 transmission risk.
ConclusionThis analysis provides a detailed description of the rela-tionship between plasma HIV-1 RNA and risk of hetero-sexual HIV-1 transmission. These findings suggest targetsfor reduction in HIV-1 RNA for use in evaluating non-ster-ilizing HIV-1 vaccine candidates in HIV-1 infected personsto reduce risk of heterosexual HIV-1 transmission.
from AIDS Vaccine 2009Paris, France. 19–22 October 2009
Published: 22 October 2009
Retrovirology 2009, 6(Suppl 3):O12 doi:10.1186/1742-4690-6-S3-O12
<supplement> <title> <p>AIDS Vaccine 2009</p> </title> <editor>Anna Laura Ross</editor> <note>Meeting abstracts – A single PDF containing all abstracts in this Supplement is available <a href="http://www.biomedcentral.com/content/files/pdf/1742-4690-6-S3-full.pdf">here</a>.</note> <url>http://www.biomedcentral.com/content/pdf/1471-2105-10-S12-info.pdf</url> </supplement>
This abstract is available from: http://www.retrovirology.com/content/6/S3/O12
© 2009 BioMed Central Ltd.
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