What Is The Danger Of Transmitting HIV?

Published in Odd and Fun on 17th July 2017
What Is The Danger Of Transmitting HIV?

Charlie Sheens recent proclamation that he has HIV has raised concerns about whether he may have transmitted the infection to other people.

While we plainly dont know his specific medical details( and really, its none of our business ), HIV therapy is effective at reducing transmitting. This is known as the treatment as prevention strategy.

There have been many advances in HIV care since Rock Hudson was diagnosed in the 1980 s. At this time, the prognosis of AIDS was similar to patients with advanced cancer.

Since the mid-1 990 s, combinations of antivirals have markedly improved the survival of people living with HIV. Modern combinations are simple to take( as few as one tablet, once a day) and links with much fewer side effect than older drugs.

The life expectancies of people living with HIV are now comparable to the general population, both in first world countries and developing countries.

Antiviral narcotics run by interfering with the replication of HIV. This outcomes in a drop in the viral loading the concentration of virus detectable in blood.

This doesnt mean, however, that the virus is eradicated. HIV can hide in sanctuary sites in the body( known as latency) and will promptly become detectable if the antivirals are stopped. In many people taking treatment, the concentration of virus is often undetectable, but this doesnt exclude the possibility of very small amounts of circulating virus that are below the frontiers of the tests that detect them.

In the epoch before treatment, it was estimated that the risk of acquiring HIV was around one in 200 sex encounters, which varied by the type of act and other factors.

There are now two new effective strategies to reduce this risk and prevent HIV infection: treating the person or persons with HIV to squelch their viral loading; and dedicating antivirals to the uninfected partner( prophylaxis) to stop them becoming infected.

It has long been known that the risk of transmitting is related to the amount of virus present in the body. A number of trials now show that therapy of the persons with HIV dramatically reduces health risks of transmission.

A trial of 1,763 couples where one partner was HIV positive and the other was HIV negative recorded only one transmission in the group on antiviral treatment compared to 27 who were not on treatment.

Two other ongoing studies have reported no transmissions in more than 1,300 couples where the HIV-positive partner was successfully treated with antivirals.

It should be noted that the participants of these trials were given the usual advice to prevent HIV transmission in addition to antiviral treatment, including the use of condoms. The initial trial primarily included heterosexual couples, but the subsequent analyses have widened the evidence to gay men.

For the uninfected partner, post-exposure prophylaxis( taking antivirals like a morning after pill) or pre-exposure prophylaxis( taking antivirals continuously like the oral contraceptive) are also effective options.

In those taking preventive antivirals, the protection against HIV infection appears to be near complete. But as with the oral contraceptive, antivirals merely work if they are taken.

The evidence suggests both strategies are highly effective at preventing HIV infection. However, antivirals do have some potential side effect. And in many countries, including Australia, they are not yet approved for prophylaxis.

They also do not protect against other sexually transmitted infections( such as syphilis or gonorrhoea) and need to be combined with other risk-reduction strategies.

Both treatment as prevention and pre-exposure prophylaxis rely on the individual knowing his or her HIV status. This strengthens the importance of diagnosing HIV, so that therapy can be offered both for the benefit of the person or persons with HIV, as well as for their uninfected partners.

Like the prevention of pregnancy, there are many potential alternatives to avoid HIV and these should be carefully considered with the person or persons treating physician. But therapy as prevention and pre-exposure prophylaxis are clearly major advances in our goal to eliminate HIV transmission.

Allen Cheng, Professor in Infectious Diseases Epidemiology, Monash University

Read more: www.iflscience.com

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