Posted on 10/10/2001 8:35:40 PM PDT by Neuromancer
Sexual Transmission During the Incubation Period of Primary HIV Infection
To the Editor: The concept that peak viremia during primary human immunodeficiency virus (HIV) infection (PHI) could be associated with concurrent high-level genital shedding1, 2 has led to the hypothesis that individuals with PHI are highly infectious. This hypothesis would in part explain rapid epidemic spread in populations3 and would suggest that PHI is an important target for public health intervention. We sought to establish that such transmission occurs and to examine the window of infectiousness during PHI.
Methods
We investigated 5 cases drawn from 4 university hospital clinics, in whom sexual transmission was suspected to have occurred between an individual with documented PHI and a sexual partner who later developed documented PHI. We defined PHI as p24 antigen positivity, RNA and/or DNA positivity, enzyme-linked immunosorbent assay negativity, or 2 or fewer bands on Western blot within 30 days. Other risk factors for transmission were excluded. Each transmission pair was confirmed by phylogenetic analysis of HIV reverse transcriptase sequences with bootstrap values greater than 99/100 using Fitch-Margoliash and least squares methods (data not shown).
Results
Transmission was woman-to-man in couple 1; man-to-woman in couples 2, 3, and 4; and man-to-man in couple 5. Couples 1 and 2 reported frequent, regular intercourse during periods of possible sexual exposure, but couples 3, 4, and 5 recalled only single sexual contacts with one another during the time of possible transmission. Except in the case of couple 2, all transmitters explained their own infection by identifying specific high-risk sexual exposures with other partners. In couples 1 through 4, transmitters infected a steady sexual partner via penile-vaginal intercourse; in couple 5, transmission was via insertive anal and oral sex. Seminal plasma HIV RNA concentrations, examined in couple 5 only, were higher than commonly seen in chronic infection1 for both transmitter and infected partner (5.7 and 5.9 log copies/mL, respectively). Other sexually transmitted infections were identified in couple 1 (genital herpes simplex virus [HSV] and chlamydia) and in couple 5 (genital HSV and early syphilis); in couple 4, the transmitter had a sterile inguinal abcess.
The timing of events for each couple is shown in Figure 1. The single reported exposure occurred before the transmitter's onset of symptoms for couples 4 (day -2) and 5 (day -7). There were multiple sexual exposures for couple 1, but all occurred prior to day +2 after the transmitter's onset of symptoms. A single exposure occurred on day +7 after symptom onset in couple 3. Observed incubation periods for transmitter 1, infected partner 3, and infected partner 4 were 20, 12, and 17 days, respectively, consistent with previous published observations.4
Comment
Our findings indicate that HIV is readily transmitted by sexual intercourse during early PHI, and that the window of sexual infectiousness in PHI can begin as early as 7 days before the onset of the acute retroviral syndrome. Each case of PHI may thus present a unique public health opportunity to abort rapid epidemic spread in sexual networks.5 Both source patients and secondary cases of PHI can be identified by urgently tracing recent sexual contacts, and secondary transmission risk can be reduced for all infected patients by counseling along with antiretroviral therapy1 and/or treatment for STDs.6
It'll be a heck of a clean-up.
That is a very interesting comment since it is well known that AIDS does not spread like any epidemic that we have ever seen. Epidemics are rapid rise to a peak and then a fall. AIDS does not have any of the features of an epidemic and it is not an epidemic, it is simply a destruction of the immune system due to avoidable life style choices like doing drugs and getting yourself infected continuously by every virus and bacterial infection known to man by having unprotected anal sex with people who are infected with every virus and bacterial infection known to man. In Africa it is primarily tuberculosis and other diseases that have wasted those poor people for ever.
This isn't rocket science. It isn't even science. If I understand this article, the author is saying that if you have an HIV cold you are more contagious then after the HIV cold is gone. Wow. That is a biggie.
Since 1991 I have followed the Virology Battles with great interest and have become an utter and complete skeptic.
Couple this with the knowledge that the human male sperm is of much greater size than the viral agent that can spread the HIV infection, and you'd have to believe the effectiveness rate of a condom against spreading HIV would be no better than 75% and perhaps not even that.
Who would consent to sex with an infected person if they knew there was a one-in-four chance of catching the infection, even from a "one-night-stand"?
Yet to hear everyone from C. Everett Kook to Joycelyn Elders to the new guy Bush won't fire because he's black, the Surgeon General says "use a condom and you're safe". Perhaps we should remember this as they advise us on the threat of other deadly viruses.
Me too. I have taken the same track as you exactly.
I don't believe that can you read that book and still believe that HIV is the cause of AIDS. AIDS is real. HIV is just another virus.
Yes that is the point of the study but that is true of all viruses. The problem with all of the studies of HIV is that they are based on the false assumption that HIV is the cause of AIDS. This is the false postulate of the whole AIDS industry and it has never been and never will be proven because it just isn't so. I will offer again as I have so many times to read anything offered up that is contrary to this position. Where is the scientific article that shows that HIV causes AIDS? Who wrote it and when did they write it?
Please don't read a lack of sympathy for AIDS victims in what I write here. I happen to believe very deeply that AIDS victims are being lied to about the cause of their illness. You can't get well if the doctor is giving you bad advice and right now they are getting very bad advice. I just do my little bit to help reverse that.
And it is not spam.
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