Sexual transmission efficiency of hepatitis B virus and human immunodeficiency virus among homosexual men

Article Abstract:

The health threat posed by HIV-1 infection (human immunodeficiency virus, type 1, which causes AIDS) may have reduced public awareness of another major disease of homosexual men, hepatitis B virus (HBV) infection. Receptive anal intercourse is considered to be the principle route for acquisition of HIV-1, while HBV is thought to spread as a result of several kinds of homosexual contact. To better understand the transmission efficiency (how effectively they are transmitted) of the two diseases, three groups of homosexual and bisexual men were studied over a 2.5-year period. Members of group 1 (776 men) were seronegative for HIV-1 (did not have evidence of the virus in their blood) at baseline; group 2 (333 men, some overlap with group 1), was seronegative for HBV (did not test positive for antibody to hepatitis B core antigen, or positive for hepatitis B surface antigen); and men in group 3 (314, a subgroup of the first two groups) were seronegative for both diseases. Seroconversion rates (rates of testing positive for these diseases) were evaluated at six-month intervals, and data regarding sexual practices were obtained. Results showed that the risk of seroconversion to both HIV-1 and HBV was greater during the first year, especially during the first six months. The proportion of men who seroconverted to HBV during the study period was 19.8 percent, and for HIV-1, 7.8 percent. This was true, even though the prevalence of hepatitis B carriers was much lower than that of HIV-1 carriers. Participating in anal intercourse was a risk factor for both infections. A higher proportion of HIV-1 seroconverters (89 percent) had engaged in receptive anal intercourse within six months of seroconversion, while this was true for 71 percent of HBV seroconverters. HBV seroconversion, on the other hand, was more highly related to insertive anal intercourse, suggesting that the urethra may be a route of infection. An independent risk factor for HBV seroconversion was prior or subsequent infection with HIV-1. The concept of relative sexual transmission efficiency (RSTE) of HBV, as compared with HIV-1, is defined, and calculated to be 8.6. The data support the use of immunization against HBV and the use of condoms during homosexual intercourse. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Sexually transmitted diseases, Prevention, Demographic aspects, HIV infection, HIV infections, Disease transmission, Hepatitis B, Sexually transmitted disease prevention, Homosexuality, Male, Male homosexuality

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Quantitation of HIV-1 RNA in plasma predicts outcome after seroconversion

Article Abstract:

Detection of HIV RNA in blood plasma samples may predict a rapid progression to AIDS. Researchers analyzed blood samples from 62 gay male participants in the Multicenter AIDS Cohort Study who had a documented conversion from HIV-negative to HIV-positive status. The samples were tested for RNA levels as well as levels of other disease markers. HIV RNA was detected in all or most samples from 16 of 18 patients who developed AIDS and 13 of 21 patients whose CD4 T-cell counts declined significantly. In contrast, HIV RNA was detected in all or most samples from only four of 23 patients whose CD4 counts remained stable, and was not detected in all or most samples from 19 of these patients. The presence of plasma HIV RNA was found to be a more reliable predictor of progression to AIDS than the other markers evaluated.

Measurement, Development and progression, HIV (Viruses), HIV, RNA, AIDS (Disease)

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