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M94A0004.TXT
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1994-10-01
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Document 0004
DOCN M94A0004
TI Antiretroviral treatment of men infected with human immunodeficiency
virus type 1 reduces the incidence of heterosexual transmission. Italian
Study Group on HIV Heterosexual Transmission.
DT 9412
AU Musicco M; Lazzarin A; Nicolosi A; Gasparini M; Costigliola P; Arici C;
Saracco A; National Research Council, University of Milano, Italy.
SO Arch Intern Med. 1994 Sep 12;154(17):1971-6. Unique Identifier :
AIDSLINE MED/94354740
AB OBJECTIVE: To determine the incidence of heterosexual human
immunodeficiency virus type 1 disease transmission and the effect of
zidovudine therapy on this risk of transmission. DESIGN: A cohort of 436
monogamous seronegative female sexual partners of human immunodeficiency
virus type 1-infected males was followed up for 740 person-years with
regular structured interviews and laboratory tests. PATIENTS: At
enrollment of the women, 50% of their infected partners had one or more
signs of disease progression (symptoms of acquired immunodeficiency
syndrome, p24 antigen positivity, or CD4+ cell counts lower than 0.4 x
10(9)/L) and 15% were treated with zidovudine. MAIN OUTCOME MEASURE:
Incidence rates of seroconversion were calculated and relative risks
were estimated as incidence rate ratios. RESULTS: Twenty-seven women
seroconverted during follow-up, and the incidence of seroconversion was
3.7 per 100 person-years. Seroconversion was about six times more
frequent (relative risk, 5.8; 95% confidence interval, 2.2 to 15.3) in
couples not using condoms. Men with signs of disease progression
transmitted infection to their partners more frequently and were more
frequently treated with zidovudine. When the risk of transmission was
estimated accounting for disease progression, the rate of transmission
in zidovudine-treated men was lower than in untreated men (relative
risk, 0.5; 95% confidence interval, 0.1 to 0.9). CONCLUSION: Treatment
of human immunodeficiency virus type-1 infected men with zidovudine
reduces, but does not eliminate, heterosexual transmission of infection.
Behavioral counseling that encourages sexual practices with a lower risk
of transmission remains the most important method of prevention.
DE Acquired Immunodeficiency Syndrome/*DRUG THERAPY/EPIDEMIOLOGY/
*TRANSMISSION Cohort Studies Confounding Factors (Epidemiology)
Female Human HIV Seronegativity *HIV-1 Incidence Male *Sex
Behavior Sexual Partners Sexually Transmitted Diseases,
Viral/EPIDEMIOLOGY/*TRANSMISSION Support, Non-U.S. Gov't
Zidovudine/*THERAPEUTIC USE JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).