Treatment interruptions and recent infection are the major periods of HIV transmission

Condoms in the faceA large proportion of HIV transmissions occur during early infection or interruptions in antiretroviral therapy, reported Swiss researchers inSeptember 19 advance edition ofClinical Infectious Diseases. Overall, 44% of the transmissions were associated with recent infection and 14% can be attributed to treatment interruptions. The authors believe these findings represent a major challenge to treatment strategies such as prevention (TASP). (Treatment of prevention). (Editor's note: This should be translated like this: TCP (Lock How Prevention), but I, the apocalyptic Cassandra, that the "North American Way "will impose here with another that imposes crippling the inglesamento the same language that is by inertial force or mental addiction. I leave here my protest)

"Our results suggest that TASP needs to be accompanied by measures to combat discontinuation of treatment, adherence, maintaining the service and, most importantly, early diagnosis," said the researchers.

Previous studies have shown that between 10% and 80% of HIV transmission are attributable to people who have recently been infected with the virus. Knowing that the proportion of early stage transmissions is important, especially given the recent emphasis on the use of HIV treatment as prevention.

Indeed, the impact of treatment in preventing ongoing epidemic can be limited if there is a high proportion of transmissions from individuals with recent infection. Many of these patients are unaware of their status and therefore are not able to benefit from ART (antiretroviral therapy). In addition, because a recent infection is associated with a high viral load, individuals during this phase of infection are often highly infectious.

Researchers with the study Swiss HIV CohortTherefore performed a retrospective analysis of genetic characteristics of stored blood samples obtained from patientsSwissPatients. Using a technique called phylogenetic analysis *, looked at infections with similar genetic profiles, which are likely to be part of a cluster transmission.

Translator's Note:biology, Phylogeny (or phylogenesis) is the study of the evolutionary relationship between groups of organisms (eg,species, populations), Which is discovered by molecular sequencing data and data arraysmorphological. the termPhylogeneticderives from the Greek termsFillet(φυλή) andFilon(φῦλον), denoting "tribe" and "breed",[1]and the termgenetic(γενετικός), denoting "relative to birth", from genesis (γένεσις) "origin" or "birth".[2]The results of phylogenetic studies is the evolutionary history of groupstaxonomicIe its phylogeny.[3]

TaxonomyThe classification, identification and designation of bodies is richly based phylogeny information but are methodologically distinct.[4]The phylogeny of fields overlap intaxonomyso phylogenetic systematics - A methodologycladísticawith features derived (sinapomorphies) Used to find the ancestral down the tree (cladogramsand delimit thetaxon(clades).[5] [6]AtsystematicBiological as a whole, analyzesPhylogeneticbecome essential in researching the evolutionary tree of life. Source Source: Wikipedia, the free encyclopedia

A total of approximately genetic sequences 19.604 11.000 patients (59% of participants cohort) were available for analysis. The year of diagnosis of HIV for people included in the analysis ranged from the 1984 2014. Most (71%) were men, AND 77% were white, and 38% were in men who have sex with men (MSM) group with the highest risk of risky behavior. * Editor's note: This is because no one deals with it, as if they, by not recognizing as gay, are nothing and therefore we do not take care of prevention among them ...

Date of seroconversion to HIV could be estimated to 4079 patients, 82% of these individuals were diagnosed during the first year after seroconversion.

The researchers identified between 71 and 378 pairs of transmission. About two-thirds (62% -66%) in men who have sex with men.

When recent infection was defined as the first year after infection, the average percent transmission attributable to recent infection ranged from a low of 41% to a maximum of 44%. When using 6 months since seroconversion as the criterion for recent infection among 28 42% and% transmissions had their origin in patients with recent infection.

The authors then looked for transmissions during the chronic phase of HIV infection. Higher viral load, lower CD4 cell count and more time for initiation of antiretroviral treatment were significantly associated with the transmissions.

About 54 121 of people (45%) who transmitted HIV during the chronic phase of infection were known to have started ART. The viral load and the data were available for these individuals 44 and 35 had at least one "measuring up 400 copies / mL (median viral load was detectable 70.800 copies / mL)." The authors suggest the 9 other patients could represent direct non-transmission in pairs (for example, an intermediate transmitter), a cluster of false positives, or lose the measurement of detectable viral load.

Additional data were obtained for the 35 people with a high viral load confirmed case who transmitted HIV during the chronic phase. In 18 these, the estimated transmission data was very close to the date the ARV treatment for HIV had already started. "These individuals handed or shortly before or shortly after the start of HAART," the authors suggested.

All but 1 17 of the other patients had a history of documented antiretroviral treatment interruption.

"Overall, the results indicate that a substantial part of the chronic phase transmission events - at least 17 of 121 persons (14%) and even 54 of 121 persons (45%) - occurred after starting ART by the issuer" He said one of the researchers. "This finding underlines the important contribution of outages and periods near ART early for onward transmission of HIV."

They conclude, "Our work highlights the recent high phase fraction of the transmission and transmission during therapy interruptions, two key challenges in reducing HIV incidence with TASP."

Category:Treatment to Prevention

Posted on Tuesday, October 06 2015 00 to: 00h.

Written by Michael Carter

[Produced in collaboration with Aidsmap.com]

Treaduzido into Portuguese in Brazil by Claudio Souza and reviews for Mara Macedo in the original English situated in HIV-1 Transmission During Recent Infection and Treatment Interruptions During the Major Drivers of New Infections in the Swiss HIV Cohort Study

Note the Soropositivo.Org Editor: It gets to me cause hives observe the unfolding of these arguments for the future, with dark mandatory testing and compulsory treatments that go against everything I know on human rights. There was, in my history as HIV-positive twice that resusei treatment and return to treatment was immediate, and there was a third vezem I condicionei maintaining my treatment to change professional (sic) Health who treated me for MEDICAL that comes to me; some will say I'm crazy and if you stop taking six pills and AZT six times a day is to be crazy so yes, I'm crazy. In other circumstances I was not psychiatrically well, and had given up living; I was three months without appearing in the house of AIDS, which linked insistently, and I did not meet to recognize the number, until they approached me through another terminal and I attended. It was a long conversation and then I presented my "list of demands" I went back to treatment.

I do not advise anyone to do what I did and if I did, that's because it lacks a pin in my brain and I play with my life and the quality of it like to get improvements for me and other patients, emboara no one knows how or because suddenly treatment after blood collection in the old CRTA also at Rua Antônio Carlos, came to have coffee, milk, bread and cold to people who, at times, came from places in São Paulo, which are " after the SECOND FERRY, "only the money back without a buck or for coffee.

It must remain, be and stay with attentive eyes and ears open to any small changes in the law or who knows where regiment, seeking to avoid things such as those described in the text that follows after this link

06 / 10 / 2015 who want to read the abstract (in English) about this item knock follow this link

Reference

The Marzel, M Shilaih, WL Yang, et al. The HIV-1 transmission during early infection and during treatment interruptions as major drivers of new infections in the Swiss HIV Cohort study.Clinical picture Infectious Diseases. 19 2015 OF SEPTEMBER

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