HIV transmission in discordant couples in Africa in the context of antiretroviral therapy availability

AIDS
Evonne WoodsonEric Hunter

Abstract

The study aims to understand the basis of continued HIV-1 transmission in Zambian and Rwandan HIV-1-discordant couples in the context of antiretroviral therapy (ART). We identified nine Zambian and seven Rwandan acutely infected, epidemiologically-linked couples from government couples' voluntary counseling and testing (CVCT) clinics where transmitting partners reported being on ART near the time of transmission. We quantified viral load and plasma antiretroviral drug concentrations near the time of transmission and used these as surrogate measures for adherence. We also sequenced the polymerase gene from both donor and recipient partners to determine the presence of drug resistance mutations (DRMs). In Zambia, all transmitting partners had detectable viral loads, and 8/9 were not on therapeutic antiretroviral regimens. In the remaining couple, despite being on a therapeutic regimen, DRMs were present and transmitted. In Rwanda, although six of seven transmitting partners had detectable viral loads, therapeutic levels of antiretroviral drugs were detected in four of seven, but were accompanied by DRMs. In the remaining three couples, either no antiretrovirals or subtherapeutic regimens were detected. A reduction of ART effectiv...Continue Reading

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Citations

Sep 4, 2020·International Journal of Epidemiology·Matt A PriceJill Gilmour
Nov 27, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Ann M DennisWilliam C Miller

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