HIV meds lower infection risk to almost zero Study

HIV meds lower infection risk to almost zero Study

New Research Review Shows Low Risk of HIV Transmission in People with Antiretroviral Therapy

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A new research review published in The Lancet has found that people on antiretroviral therapy (ART) for HIV with low but detectable virus levels have an almost negligible risk of transmitting the virus to others. This review, conducted by the Global Health Impact Group and the World Health Organization, analyzed eight studies involving over 7,700 couples in 25 countries. The findings provide important insights into HIV transmission and have significant implications for public health policies.

Previous studies had suggested that the risk of transmission is still present even at viral loads below 200 copies/mL. However, this new review challenges that notion. It shows that individuals with HIV who have viral loads below 1,000 copies/mL have an incredibly low risk of transmitting the virus to their sexual partners. In fact, out of the 320 documented sexual HIV transmissions analyzed in the review, only two involved a partner with a viral load below 1,000 copies/mL.

The study reinforces previous research that has demonstrated the effectiveness of maintaining undetectable viral loads in preventing HIV transmission. People whose virus levels are undetectable due to successful ART have essentially no risk of transmitting the virus to their sexual partners. This is a crucial finding that highlights the importance of HIV treatment adherence and viral load monitoring.

Lead author Dr. Laura Broyles from the Global Health Impact Group in Atlanta emphasizes the significance of these findings. She states, “These findings are important as they indicate that it is extremely rare for people who maintain low levels of HIV to transmit it to their sexual partners.” Dr. Broyles further suggests that these conclusions can promote alternative viral load testing modalities that are more feasible in resource-limited settings.

Improving access to routine viral load testing can have a profound impact on the lives of people with HIV and help reduce the transmission of the virus. Currently, global efforts are focused on achieving undetectable viral loads through the use of antiretroviral therapy (ART). Additionally, initiatives to decriminalize HIV and reduce stigma and discrimination for people living with the virus are ongoing.

It is worth noting that without ART, individuals with HIV can have viral loads ranging from 30,000 to over 500,000 copies/mL, depending on the stage of infection. Therefore, ART plays a crucial role in not only improving health outcomes for people with HIV but also in preventing the spread of the virus to others.

To support the findings of this research review, the World Health Organization (WHO) is publishing a new policy brief. This brief provides updated prevention and testing guidance for policymakers, public health professionals, and people with HIV. The objective is to ensure that all individuals living with HIV have access to antiretroviral therapy in order to achieve undetectable viral loads, thereby reducing transmission to their sexual partners and potential future children.

The authors of the review searched databases for studies published between January 2000 and November 2022 to assess transmission risk at varying viral loads. While lab-based plasma sample tests are the most sensitive, the findings also support the use of simpler testing approaches like dried blood spot samples. These less resource-intensive methods could improve access to viral load testing, especially in resource-limited settings.

The research review’s findings specifically refer to sexual transmission of HIV and may not apply to transmission from mother to child. Mother-to-child transmission has different dynamics, and preventing new infections in children requires ensuring that pregnant and breastfeeding women maintain undetectable viral loads throughout the entire exposure period.

The research was funded by the Bill & Melinda Gates Foundation, underscoring the commitment of various stakeholders to support advancements in HIV prevention and treatment strategies.

In conclusion, this groundbreaking research review provides valuable insights into HIV transmission among individuals on antiretroviral therapy. People with low but detectable virus levels have an exceptionally low risk of transmitting HIV to their sexual partners. These findings emphasize the importance of ART adherence, routine viral load testing, and global efforts to achieve undetectable viral loads. By expanding access to testing and improving treatment options, we can ultimately help people with HIV live healthier lives and reduce the transmission of the virus.

The Lancet
The U.S. National Institutes of Health