Lack of Effectiveness of Antiretroviral Therapy in Preventing HIV Infection in Serodiscordant Couples in Uganda: An Observational Study.

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dc.contributor.authorBirungi, Josephine
dc.contributor.authorMin, Jeong Eun
dc.contributor.authorMuldoon, Katherine A.
dc.contributor.authorKaleebu, Pontiano
dc.contributor.authorKing, Rachel
dc.contributor.authorKhanakwa, Sarah
dc.contributor.authorNyonyintono, Maureen
dc.contributor.authorChen, YaLin
dc.contributor.authorMills, Edward J.
dc.contributor.authorLyagoba, Fred
dc.contributor.authorRagonnet-Cronin, Manon
dc.contributor.authorWangisi, Jonathan
dc.contributor.authorLourenco, Lillian
dc.contributor.authorMoore, David M.
dc.date.accessioned2018-07-26T06:28:36Z
dc.date.available2018-07-26T06:28:36Z
dc.date.issued2015-07-14
dc.descriptionThe study examined the real-world effectiveness of ART as an HIV prevention tool among HIV serodiscordant couples in a programmatic setting in a low-income country.en_US
dc.description.abstractBackground We examined the real-world effectiveness of ART as an HIV prevention tool among HIV serodiscordant couples in a programmatic setting in a low-income country. Methods We enrolled individuals from HIV serodiscordant couples aged >18 years of age in Jinja, Uganda from June 2009 – June 2011. In one group of couples the HIV positive partner was receiving ART as they met clinical eligibility criteria (a CD4 cell count >250 cells/ μL or WHO Stage III/IV disease). In the second group the infected partner was not yet ARTeligible. We measured HIV incidence by testing the uninfected partner every three months. We conducted genetic linkage studies to determine the source of new infections in seroconverting participants. Results A total of 586 couples were enrolled of which 249 (42%) of the HIV positive participants were receiving ART at enrollment, and an additional 99 (17%) initiated ART during the study. The median duration of follow-up was 1.5 years. We found 9 new infections among partners of participants who had been receiving ART for at least three months and 8 new infections in partners of participants who had not received ART or received it for less than three months, for incidence rates of 2.09 per 100 person-years (PYRs) and 2.30 per 100 PYRs, respectively. The incidence rate ratio for ART-use was 0.91 (95% confidence interval 0.31-2.70; p=0.999). The hazard ratio for HIV seroconversion associated with ART-use by the positive partner was 1.07 (95% CI 0.41-2.80). A total of 5/7 (71%) of the transmissions on ART and 6/7 (86%) of those not on ART were genetically linked. Conclusion Overall HIV incidence was low in comparison to previous studies of serodiscordant couples. However, ART-use was not associated with a reduced risk of HIV transmission in this study.en_US
dc.description.sponsorshipThe study was funded by CIHR (Grant numbers MOP-8970, HBF-112308 and MHI-I26391) and CANFAR (Grant number 023 502).en_US
dc.identifier.citationBirungi, Josephine, Min, Jeong Eun, Muldoon, Katherine A., Kaleebu, Pontiano, King, Rachel, Khanakwa, Sarah, Nyonyintono, Maureen, Chen, YaLin, Mills, Edward J., Lyagoba, Fred, Ragonnet-Cronin, Manon, Wangisi, Jonathan, Lourenco, Lillian, Moore, David M., 2015. Lack of Effectiveness of Antiretroviral Therapy in Preventing HIV Infection in Serodiscordant Couples in Uganda: An Observational Study.en_US
dc.identifier.urihttps://hdl.handle.net/20.500.11951/306
dc.language.isoenen_US
dc.subjectTherapyen_US
dc.subjectHIVen_US
dc.subjectHIV Infectionen_US
dc.subjectSerodiscordant Couplesen_US
dc.subjectUgandaen_US
dc.titleLack of Effectiveness of Antiretroviral Therapy in Preventing HIV Infection in Serodiscordant Couples in Uganda: An Observational Study.en_US
dc.typeArticleen_US
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The final, definitive version of this paper has been published in the PLOS ONE, Vol.10, No 7, July 14, 2015. DOI:10.1371/journal.pone.0132182.
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