Low-Level HIV Transmission Risk Almost Zero at Suppressed Viral Loads: Study
People living with HIV who maintain low, but still detectable, levels of the virus and adhere to their antiretroviral regimen have almost zero risk of transmitting it to their sexual partners, according to a recent systematic review published in The Lancet. The study indicates that the risk of sexual transmission of the human immunodeficiency virus is almost negligible when the viral load is less than 1,000 copies per milliliter of blood, also known as having a suppressed viral load.
Lead author Laura Broyles, from the Global Health Impact Group in Atlanta, US, emphasized the significance of these findings in promoting the expansion of alternative viral load testing methods that are more feasible in resource-limited settings. 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, Broyles stated. She further mentioned that improving access to routine viral load testing could have a positive impact on the overall health and well-being of individuals with HIV and help minimize the transmission of the virus.
Antiretroviral therapy (ART), which involves taking daily medication to treat HIV, significantly reduces the amount of the virus in the body, preserving immune function and lowering morbidity and mortality associated with the virus. ART also plays a crucial role in reducing HIV progression. Without ART, individuals with HIV can have viral loads ranging from 30,000 to over 500,000 copies per milliliter, depending on the stage of infection.
The systematic review conducted by researchers included eight studies involving 7,762 serodiscordant couples across 25 countries. Serodiscordant couples consist of one partner who is living with HIV. Of the 323 sexual transmissions of HIV detected in all eight studies, only two occurred when the partner had a viral load of less than 1,000 copies per milliliter. Notably, in both cases, the viral load test was performed at least 50 days before transmission, suggesting a potential increase in viral load following the test.
In studies that provided data on a full range of viral loads in partners with HIV, it was found that over 80% of transmissions involved viral loads exceeding 10,000 copies per milliliter. Co-author Lara Vojnov from the World Health Organization commented on the ultimate goal of antiretroviral therapy, saying, The ultimate goal of antiretroviral therapy for people living with HIV is to maintain undetectable viral loads, which will improve their own health and prevent transmission to their sexual partners and children.
The findings of this study hold significant implications in destigmatizing HIV and promoting the benefits of adhering to antiretroviral therapy. Lara Vojnov further highlighted the importance of these results in supporting individuals living with HIV and their efforts to prevent transmission. By maintaining low viral loads, individuals not only improve their personal health but also significantly reduce the risk of transmitting the virus to their sexual partners.
In conclusion, this systematic review emphasizes that people living with HIV who adhere to antiretroviral therapy and maintain low levels of the virus have an almost negligible risk of transmitting it to their sexual partners. These findings underscore the importance of routine viral load testing and the significance of achieving and maintaining suppressed viral loads. By expanding access to testing and treatment, individuals with HIV can live healthier lives while also minimizing the transmission of the virus.
