Antiretroviral Treatment of Men Infected With Human Immunodeficiency Virus Type 1 Reduces the Incidence of Heterosexual Transmission

doi:10.1001/archinte.1994.00420170123012

You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.

Vol. 154 No. 17, 12 September 1994

Online Only
	•	Online First Table of Contents

Original Investigations

•	Online Features

This Article
•	References
•	Full text PDF
•	Reply to article
•	Send to a friend
•	Save in My Folder
•	Save to citation manager
•	Permissions

Citing Articles
•	Citation map
•	Citing articles on HighWire
•	Citing articles on Web of Science (77)
•	Contact me when this article is cited

Related Content
•	Similar articles in this journal

Social Bookmarking
	What's this?

Antiretroviral Treatment of Men Infected With Human Immunodeficiency Virus Type 1 Reduces the Incidence of Heterosexual Transmission

Massimo Musicco, MD; Adriano Lazzarin, MD; Alfredo Nicolosi, MD, PhD; Maddalena Gasparini, MD; Paolo Costigliola, MD; Claudio Arici, MD; Alberto Saracco, MD; Italian Study Group on HIV Heterosexual Transmission

Arch Intern Med. 1994;154(17):1971-1976.

Abstract

Objective
To determine the incidence of heterosexual human immunodeficiencyvirus type 1 disease transmission and the effect of zidovudinetherapy on this risk of transmission.

Design
A cohort of 436 monogamous seronegative female sexual partnersof human immunodeficiency virus type 1—infected maleswas followed up for 740 person-years with regular structuredinterviews and laboratory tests.

Patients
At enrollment of the women, 50% of their infected partners hadone or more signs of disease progression (symptoms of acquiredimmunodeficiency syndrome, p24 antigen positivity, or CD4⁺ cellcounts lower than 0.4x10⁹/L) and 15% were treated with zidovudine.

Main Outcome Measure
Incidence rates of seroconversion were calculated and relativerisks were estimated as incidence rate ratios.

Results
Twenty-seven women seroconverted during follow-up, and the incidenceof seroconversion was 3.7 per 100 person-years. Seroconversionwas about six times more frequent (relative risk, 5.8; 95% confidenceinterval, 2.2 to 15.3) in couples not using condoms. Men withsigns of disease progression transmitted infection to theirpartners more frequently and were more frequently treated withzidovudine. When the risk of transmission was estimated accountingfor disease progression, the rate of transmission in zidovudine-treatedmen was lower than in untreated men (relative risk, 0.5; 95%confidence interval, 0.1 to 0.9).

Conclusion
Treatment of human immunodeficiency virus type—1 infectedmen with zidovudine reduces, but does not eliminate, heterosexualtransmission of infection. Behavioral counseling that encouragessexual practices with a lower risk of transmission remains themost important method of prevention.

(Arch Intern Med. 1994;154:1971-1976)

Author Affiliations

From the National Research Council and Department of Epidemiology and Medical Informatics, Institute of Advanced Biomedical Technologies (Drs Musicco, Nicolosi, and Gasparini); Clinic of Infectious Diseases, University of Milano, Istituto di Ricoveroe Cura a Carattere Scientifico, San Raffaele (Drs Lazzarin and Saracco), Milan, Italy; Institute of Infectious Diseases, University of Bologna (Italy) (Dr Costigliola); and Department of Infectious Diseases, Hospital of Bergamo (Italy) (Dr Arici).

Add to CiteULike CiteULike Add to Connotea Connotea Add to Delicious Delicious Add to Digg Digg Facebook Add to Reddit Reddit Add to Technorati Technorati Twitter What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Antiretroviral combination therapy markedly reduces risk of heterosexual HIV-1 transmission
Lichterfeld and Rosenberg
Evid. Based Med. 2011;0:ebmed.2011.100278v1-ebmed-2011-100278.
FULL TEXT

Treatment to Prevent Transmission of HIV-1
Cohen and Gay
Clinical Infectious Diseases 2010;50:S85-S95.
ABSTRACT | FULL TEXT

Contraception and HIV infection in women
Heikinheimo and Lahteenmaki
Hum Reprod Update 2009;15:165-176.
ABSTRACT | FULL TEXT

Expanded Access to Highly Active Antiretroviral Therapy: A Potentially Powerful Strategy to Curb the Growth of the HIV Epidemic
Lima et al.
The Journal of Infectious Disease 2008;198:59-67.
ABSTRACT | FULL TEXT

Cost-Effectiveness of HIV Screening in Patients Older than 55 Years of Age
Sanders et al.
ANN INTERN MED 2008;148:889-903.
ABSTRACT | FULL TEXT

Preventing Sexual Transmission of HIV
Cohen
Clinical Infectious Diseases 2007;45:S287-S292.
ABSTRACT | FULL TEXT

Narrative Review: Antiretroviral Therapy to Prevent the Sexual Transmission of HIV-1
Cohen et al.
ANN INTERN MED 2007;146:591-601.
ABSTRACT | FULL TEXT

Management of Herpes Simplex Virus Type 2 Infection in HIV Type 1-Infected Persons
Strick et al.
Clinical Infectious Diseases 2006;43:347-356.
ABSTRACT | FULL TEXT

Knowledge of Partners' Genital Herpes Protects against Herpes Simplex Virus Type 2 Acquisition
Wald et al.
The Journal of Infectious Disease 2006;194:42-52.
ABSTRACT | FULL TEXT

Reducing HIV-1 transmission through prevention strategies targeting HIV-1-seropositive individuals
McClelland and Baeten
J Antimicrob Chemother 2006;57:163-166.
ABSTRACT | FULL TEXT

Screening for HIV: A Review of the Evidence for the U.S. Preventive Services Task Force
Chou et al.
ANN INTERN MED 2005;143:55-73.
ABSTRACT | FULL TEXT

Decreased HIV Transmission after a Policy of Providing Free Access to Highly Active Antiretroviral Therapy in Taiwan
Fang et al.
The Journal of Infectious Disease 2004;190:879-885.
ABSTRACT | FULL TEXT

Can Antiretroviral Therapy Be Used to Prevent Sexual Transmission of Human Immunodeficiency Virus Type 1?
Hosseinipour et al.
Clinical Infectious Diseases 2002;34:1391-1395.
ABSTRACT | FULL TEXT

The repertoire of human efforts to avoid sexually transmissible diseases: past and present Part 1: Strategies used before or instead of sex
Donovan
Sex. Transm. Infect. 2000;76:7-12.
ABSTRACT | FULL TEXT

A Tale of Two Futures: HIV and Antiretroviral Therapy in San Francisco
Blower et al.
Science 2000;287:650-654.
ABSTRACT | FULL TEXT

Nucleoside Analogues Achieve High Concentrations in Seminal Plasma: Relationship between Drug Concentration and Virus Burden
Pereira et al.
The Journal of Infectious Disease 1999;180:2039-2043.
ABSTRACT | FULL TEXT

Antiretroviral-Drug Concentrations in Semen: Implications for Sexual Transmission of Human Immunodeficiency Virus Type 1
Kashuba et al.
Antimicrob. Agents Chemother. 1999;43:1817-1826.
FULL TEXT

Public Health Implications of Antiretroviral Therapy and HIV Drug Resistance
Wainberg and Friedland
JAMA 1998;279:1977-1983.
ABSTRACT | FULL TEXT

| | |