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VERY IMPORTANT STUDY - Sexual Transmission During the Incubation Period of Primary HIV Infection
JAMA ^ | 10-10-01 | Christopher D. Pilcher, MDJoseph J. Eron, Jr, MDDepartment of MedicineUniversity of North Caro

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  


TOPICS: Extended News; News/Current Events
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This information is a bit technical, but crucial to our understanding of HIV transmission. The period of early infection (when a carrier is unaware of having seroconverted to HIV+) happens to be the period where he/she is a walking biohazard.
1 posted on 10/10/2001 8:35:40 PM PDT by Neuromancer
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To: Neuromancer
There is a solution: Monogamy.
2 posted on 10/10/2001 8:45:46 PM PDT by fone
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To: Neuromancer
I guess being unattractive DOES has it's perks! Yeah ME!
3 posted on 10/10/2001 8:46:08 PM PDT by Texaggie79
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To: Neuromancer
From the beginning, HIV and AIDS should have been treated like medical problems instead of political problems.

It'll be a heck of a clean-up.

4 posted on 10/10/2001 8:48:20 PM PDT by martian_22
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Comment #5 Removed by Moderator

To: martian_22
Yes, yes, yes....

Normal contact tracing and screening would have stopped it in it's early stages. But due to the political power of the homosexual lobby we are left with this horror.
6 posted on 10/10/2001 8:51:48 PM PDT by Neuromancer
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To: fone
This hypothesis would in part explain rapid epidemic spread in populations

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.

7 posted on 10/10/2001 8:56:31 PM PDT by InterceptPoint
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To: InterceptPoint
I believe the point of the study is to add further proof that the period of time after an initial infection with HIV is the point where a person is sluffing off vast quantities of the virus. Thus making them highly infectious to others.

There are a few people who do not believe that the HIV virus causes AIDS - some even spam every HIV related thread on FR - I never know what to say to them...

As to your point about this epidemic not reaching a peak - this horror that has been visited upon us is killing at an ever increasing rate in more and more countries. It will reach a peak - but that is going to be a very sad day.
8 posted on 10/10/2001 9:10:18 PM PDT by Neuromancer
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To: InterceptPoint
Spot on.
9 posted on 10/10/2001 9:11:23 PM PDT by jeremiah
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To: fone
Good thing I have one lifetime partner and her only lifetime partner is me. AIDS discussions aren't very scary to some of us.
10 posted on 10/10/2001 9:17:05 PM PDT by lmr
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To: Neuromancer
bttt
11 posted on 10/10/2001 9:17:39 PM PDT by Don Myers
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To: Neuromancer
I saw the part about genital shedding, and I thought this article was about Osama or Mullah Omar.
12 posted on 10/10/2001 9:19:32 PM PDT by Bill Rice
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To: Neuromancer
Uh,...........guess I'll be cancelling that membership to the Adult Friend Finder Network.
13 posted on 10/10/2001 9:19:38 PM PDT by Hammerhead
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To: InterceptPoint
I highly advise anyone who hasn't already to read "Inventing The AIDS Virus" by Dr. Peter Duesberg, one of the discoverers of retro-viruses (RNA to DNA).

Duesberg.com

Since 1991 I have followed the Virology Battles with great interest and have become an utter and complete skeptic.


14 posted on 10/10/2001 9:20:13 PM PDT by oioiman
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To: Neuromancer
There has already been a study done that suggested that transmission of HIV is more likely to occur from a person who also has genital ulcers. That study supported the hypothesis that persons who have HIV and genital herpes may transmit HIV infection to others more easily than those who are not HSV-2 infected.

two transmitters in the above cases had genital herpes, which would seem to bias the control.
15 posted on 10/10/2001 10:25:04 PM PDT by stylin19a
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To: Neuromancer
What I always found suspicious was that, as a college student in the 70s, I was told that a condom was only 88% effective in preventing pregnancy. That's before they became the politically correct silver bullet of the homosexual AIDS lobby in the 80s.

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.

16 posted on 10/10/2001 10:45:12 PM PDT by Tall_Texan
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To: stylin19a
Your point is well taken.
17 posted on 10/10/2001 10:45:44 PM PDT by Neuromancer
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To: lmr
you got that right. hubby and I were tested some years back for a life insurance policy.
I wanted to get a t-shirt that said "HIV free in 1993"...=)
18 posted on 10/11/2001 1:35:10 AM PDT by fone
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To: oioiman
highly advise anyone who hasn't already to read "Inventing The AIDS Virus" by Dr. Peter Duesberg, one of the discoverers of retro-viruses (RNA to DNA).

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.

19 posted on 10/11/2001 5:22:07 AM PDT by InterceptPoint
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To: Neuromancer
I believe the point of the study is to add further proof that the period of time after an initial infection with HIV is the point where a person is sluffing off vast quantities of the virus. Thus making them highly infectious to others.

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.

20 posted on 10/11/2001 5:34:43 AM PDT by InterceptPoint
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