Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date.
Sunday Times (Johannesburg) - May 8, 2005
Claire Keeton, Johannesburg
A major study published in the May Journal of Infectious Disease provides the first evidence of sharply increased transmission risk during the first stage of infection, which lasts about five months.
The first three weeks of infection are the most contagious, but standard tests in this "window period" do not detect the virus.
The Ugandan study results, published by Dr Maria Wawer and 13 co-authors, showed that nearly half of HIV infections among couples occurred within 10 weeks of the initial infection of one partner. More than 15000 adults were enrolled in the study carried out between 1994 and 1999.
Professor Myron Cohen, from the University of North Carolina Center for Aids Research, said in an interview: "It is so important we find people in the early stages of HIV infection, as they are unbelievably contagious and would not normally seek healthcare."
Cohen said that the risk increased when a person also had a sexually transmitted disease.
Few people, who are newly infected with HIV, experience symptoms or, if they do, their flu-like symptoms are mild.
Cohen recommended a new, cheaper system of testing found by US researchers to be effective in early detection of the virus. The technique involves pooling samples of blood and testing them together.
South African researchers are already trying out the new system to identify recent infections in a pilot project at a clinic in Johannesburg.
Dr Francois Venter, clinical director of the Wits Reproductive Health and HIV Research Unit at the Esselen Street clinic in Hillbrow, Johannesburg, said the preliminary results were disturbing.
Venter said that early detection could help reduce risky behaviour and improve prevention and treatment of the disease.
"For example, if we find the infections can be traced to people frequenting a bar, or among students at a certain school, we can intervene, like any other infectious outbreak, and try to contain it early on," he said.
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