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Wednesday, 29 March, 2000, 23:15 GMT 00:15 UK
HIV risk claim worries experts

A cocktail of drugs can keep HIV levels low
HIV patients who have low levels of the virus in their bloodstream are far less likely to pass on the infection, say experts.

However, HIV support groups say they are concerned that the discovery could lead to an increase in unprotected heterosexual and homosexual sex.

The success of anti-retroviral treatments for HIV is measured in the "viral load" of the patient - essentially the amount of virus that can be spotted in a blood sample.

It has always been thought that patients with the lowest viral loads could be less likely to infect other people during sex, but this has never been proven through research.

The new study, reported in the New England Journal of Medicine, examined heterosexual couples, one of whom had HIV.

The two-and-a-half year survey followed more than 400 couples in Uganda, checking how many went on to infect their long-term sexual partners.

All of the couples received free condoms and HIV counselling.

Nearly all the cases in which the infection was passed involved an HIV patient with more than 10,000 copies of HIV in every millilitre of blood.

Where the patient had only 1,500 copies or below, there were no cases of the virus being passed on.

In all, 22% of the long-term partners became HIV positive during the course of the study.

In addition, circumcised men were less likely to acquire the virus - confirming earlier studies - but younger couples seemed to be at higher risk.

Doubled risk

Dr Thomas Quinn, a professor of medicine at Johns Hopkins University in the US, led the study.

He said: "With every 10-fold rise in the concentration of HIV in the bloodstream, transmission more than doubled.

"Theoretically, just as drugs have helped reduce mother to child transmission, antiretroviral regimens that dampen HIV viral load should also be effective against the heterosexual transmission of HIV."

Such antiretroviral treatments are more readily available in the UK, and many patients achieve a situation in which the level of the HIV virus is so low in the blood that it cannot be detected by normal methods.

However, an expert with the Terrence Higgins Trust warned against complacency in the light of the research.

Jeffrey Williams, a treatment specialist, said: "This is a logical finding which has been suspected for some time, but there has been no proof.

"It has implications for everywhere - but even if you have undetectable viral load you should still wear a condom.

"We are getting more and more information about the risks of transmission, and this sort of finding could be misused."

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See also:

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