World Health Organization Reaffirms HIV Treatment Is Prevention

[Jim Allen]

Nothing new, and the review was a bit like telling us water is wet, and I wouldn't say I like how it's written. Anyhow, the only news is the WHO is reaffirming what was already known and updated its own guidelines regarding PLHIV with a VL below 1000 copies.

POZ.com article: https://www.poz.com/article/world-health-organization-affirms-hiv-treatment-prevention

In Short:

World Health Organization Reaffirms HIV Treatment Is Prevention

People with HIV who have an undetectable viral load have zero risk of transmitting the virus to their sex partners.

In a move long encouraged by advocates, the World Health Organization (WHO) today reaffirmed that people living with HIV who consistently take antiretroviral treatment and have an undetectable viral load do not transmit the virus during sex

According to the WHO policy brief, released at the International AIDS Society Conference on HIV Science (#IAS2023) in Brisbane, Australia, people with an undetectable viral load who continue to take their medication as prescribed “have zero risk of transmitting HIV to their sexual partner(s)” and “minimal risk of transmitting HIV vertically to their children.” What’s more, people with a suppressed but detectable viral load “have almost zero or negligible risk” of sexual transmission. Data on the link between viral load and transmission via shared drug injection equipment are inadequate.

The review authors assessed evidence about sexual transmission of HIV linked to viral load in published studies and abstracts from 2010 to 2020 and other relevant data before 2010. They “found sexual HIV transmission to be absent” in cases involving a viral load less than 600 copies and “exceedingly rare” when viral load is below 1,000, Linda-Gail Bekker, MD, PhD, of the University of Cape Town, and colleagues wrote in an accompanying comment.

Vojnov and colleagues identified eight relevant studies with a total of 7,762 serodiscordant couples, mostly male/female. In three studies, there was no transmission when the HIV-positive partner had a viral load below 200. In four other prospective studies, there were 323 cases of HIV transmission, none of which occurred when partners with HIV were on stable suppressive antiretroviral treatment. Across all studies, there were two cases of transmission when the HIV-positive partner may have had a viral load below 1,000, but these are difficult to interpret due to the timing of viral load tests. Most transmission occurred when the HIV-positive partner had a high viral load above 10,000.

AIDSMAP: https://www.aidsmap.com/news/jul-2023/amber-light-world-health-organizations-position-when-hiv-viral-load-suppressed-not