| Title: |
Acute HIV infection detection and immediate treatment estimated to reduce transmission by 89% among men who have sex with men in Bangkok |
| Authors: |
Kroon, EDMB; Phanuphak, N; Shattock, AJ; Fletcher, JLK; Pinyakorn, S; Chomchey, N; Akapirat, S; De Souza, MS; Robb, ML; Kim, JH; Van Griensven, F; Ananworanich, J; Wilson, DP |
| Source: |
urn:ISSN:1758-2652 ; Journal of the International AIDS Society, 20, 1, 21708 |
| Publisher Information: |
Wiley |
| Publication Year: |
2017 |
| Collection: |
UNSW Sydney (The University of New South Wales): UNSWorks |
| Subject Terms: |
3207 Medical Microbiology; 32 Biomedical and Clinical Sciences; 3202 Clinical Sciences; Infectious Diseases; Sexual and Gender Minorities (SGM/LGBT*); HIV/AIDS; Infection; Acute Disease; Adult; HIV Infections; Homosexuality; Male; Humans; Prospective Studies; Risk Factors; Sexual Behavior; Thailand; Time-to-Treatment; Viral Load; HIV; acute infection; antiretroviral therapy; behavioural interventions; men who have sex with men; models/projections; prevention of sexual transmission; anzsrc-for: 3207 Medical Microbiology; anzsrc-for: 32 Biomedical and Clinical Sciences; anzsrc-for: 3202 Clinical Sciences; anzsrc-for: 1103 Clinical Sciences |
| Description: |
Introduction: Antiretroviral treatment (ART) reduces HIV transmission. Despite increased ART coverage, incidence remains high among men who have sex with men (MSM) in many places. Acute HIV infection (AHI) is characterized by high viral replication and increased infectiousness. We estimated the feasible reduction in transmission by targeting MSM with AHI for early ART. Methods: We recruited a cohort of 88 MSM with AHI in Bangkok, Thailand, who initiated ART immediately. A risk calculator based on viral load and reported behaviour, calibrated to Thai epidemiological data, was applied to estimate the number of onwards transmissions. This was compared with the expected number without early interventions. Results: Forty of the MSM were in 4th-generation AHI stages 1 and 2 (4thG stage 1, HIV nucleic acid testing (NAT)+/4thG immunoassay (IA)-/3rdG IA-; 4thG stage 2, NAT+/4thG IA+/3rdG IA-) while 48 tested positive on third-generation IA but had negative or indeterminate western blot (4thG stage 3). Mean plasma HIV RNA was 5.62 log 10 copies/ml. Any condomless sex in the four months preceding the study was reported by 83.7%, but decreased to 21.2% by 24 weeks on ART. After ART, 48/88 (54.6%) attained HIV RNA |
| Document Type: |
article in journal/newspaper |
| Language: |
unknown |
| Relation: |
https://hdl.handle.net/1959.4/unsworks_53418; https://doi.org/10.7448/IAS.20.1.21708 |
| DOI: |
10.7448/IAS.20.1.21708 |
| Availability: |
https://hdl.handle.net/1959.4/unsworks_53418; https://doi.org/10.7448/IAS.20.1.21708 |
| Rights: |
open access ; https://purl.org/coar/access_right/c_abf2 ; CC BY ; https://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.C145E2D |
| Database: |
BASE |