The role of primary infection in epidemic HIV transmission. NLM AIDSLINE Important note: Information in this article was accurate in 1993. The state of the art may have changed since the publication date.

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The role of primary infection in epidemic HIV transmission.

Int Conf AIDS. 1993 Jun 6-11;9(1):100 (abstract no. WS-C19-5). Unique Identifier : AIDSLINE MED/93333225
Koopman JS; Jacquez JA; Simon CP; Haber M; U. of Mich.

Abstract: BACKGROUND: HIV infection onsets during the early epidemic show a rise and fall that is sharp in comparison with the changes in behavior. This difference is striking in the MACS data. A sharp peak in contagiousness during primary infection could explain the infection pattern. METHODS: MACS and associated CCS data from Chicago were used. Total transmission potential during primary and subsequent infection stages has been estimated using individual prospective risk data from 1984-89. A survival analysis approach with parameters formulated as transmission probabilities and with time dependent covariates is used. The likelihood of partners being infected is derived from infection stages of other study subjects having the same type of partnership. Deterministic simulations with stage specific contagiousness were performed and estimates of contagiousness by stage are being pursued by fitting these to HIV prevalence and CD4 levels in 1984 as well as subsequent seroconversions. RESULTS: The survival analysis approach shows that primary infection accounts for 12 times as many transmissions as the subsequent stages of infection. However, confidence intervals are broad. Preliminary results from parameter fitting in the deterministic transmission models are consistent with the individual method in that high transmissibility during primary infection is needed to fit the infection patterns. Estimation using the population approach should have narrower confidence intervals than the survival analysis since the population effects of risk factors are theoretically stronger than the individual level effects. SIGNIFICANCE: Protection against transmission from antibody negative individuals experiencing primary infection should be the focus of acute HIV epidemic control.
Keywords: *Acquired Immunodeficiency Syndrome/EPIDEMIOLOGY *HIV Infections/EPIDEMIOLOGY *HIV Infections/TRANSMISSIONKWDacquiredimmunodeficiencysyndrome/epidemiologyKWDhivinfections/epidemiologyKWDhivinfections/transmission
931130
M93B5822

Copyright © 1993 - National Library of Medicine. Reproduced under license with the National Library of Medicine, Bethesda, MD.

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