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. 2008 Sep;12(5):677-84.
doi: 10.1007/s10461-007-9329-1. Epub 2007 Dec 7.

Probability of HIV transmission during acute infection in Rakai, Uganda

Steven D Pinkerton  1
Affiliations

Probability of HIV transmission during acute infection in Rakai, Uganda

Steven D Pinkerton. AIDS Behav. 2008 Sep.

Abstract

Accurate estimates of the probability of HIV transmission during various stages of infection are needed to inform epidemiological models. Very limited information is available about the probability of transmission during acute HIV infection. We conducted a secondary analysis of published data from the Rakai, Uganda seroconversion study. Mathematical and computer-based models were used to quantify the per-act and per-partnership transmission probabilities during acute and chronic HIV infection, and to estimate how many of the transmission events reported in the Rakai study were due to acute-phase HIV transmission. The average per-act transmission probability during acute infection equaled 0.03604 vs. 0.00084 for chronic HIV infection. Overall, HIV was transmitted during acute infection in 46.5% of 23 "incident index partner couples." Acute-phase transmission accounted for 89.1% of all transmission events in the first 20 months of follow-up. These results highlight the substantial risk of transmission during acute HIV infection.

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Figures

Fig. 1
Fig. 1
“Early” and “middle” transmission groups. Both partners were HIV-negative at month 0 and the index partner tested HIV-positive at month 10. In 10 of 23 couples, the non-index partner also tested positive at month 10 (“early transmission couples”) and in 2 of the remaining 13, the non-infected partner tested positive at month 20 (“middle transmission couples”). Each seroconversion period corresponds to a transmission risk period that began S days where S is the number of days between HIV acquisition and seroconversion. Notice that transmission events that occurred within the overlap of seroconversion period 1 and transmission risk period 2 would be recorded as seroconversion events in period 2. Some of these transmission events could be due to acuti-phase HIV transmission
Fig. 2
Fig. 2
Schematic illustration of variability in the per-act transmission probability during the course of acute HIV infection, which begins on day 0 and ends just prior to day A, which marks the beginning of the chronic-phase of infection. The probability of HIV transmission peaks on day P. The peak per-act HIV transmission probability is denoted αP, whereas αC represents the chronic-phase transmission probability. For the simulation model described in the text. A = 49, P = 14, αC = 0.00084, and αP = 0.07148
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References

    1. Association of State and Territorial Health Officials Acute HIV infection—an opportunity to enhance primary prevention. ASTHO Bulletin. 2006;(March):1–16.
    1. Brookmeyer R, Gail MH. AIDS epidemiology: A quantitative approach. Oxford University Press; New York: 1994.
    1. Busch MP, Satten GA. Time course of viremia and antibody seroconversion following human immunodeficiency virus exposure. American Journal of Medicine. 1997;102:117–126. - PubMed
    1. Cohen MS, Pilcher CD. Amplified HIV transmission and new approaches to HIV prevention. Journal of Infectious Diseases. 2005;191:1391–1393. - PubMed
    1. Gray RH, Li X, Kigozi G, Serwadda D, Nalugoda F, Watya S, Reynolds SJ, Wawer M. The impact of male circumcision on HIV incidence and cost per infection prevented: A stochastic simulation model from Rakai, Uganda. AIDS. 2007;21:845–850. - PubMed

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