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viral load and risk of transmission
Oct 29, 2001

Doctor, I have been reading a number of studies which indicate that the risk of transmission increases with increased viral load and that the risk of transmission (heterosexual) when one the infected partner has a viral load of 1500 or less is zero. Can you comment on this based upon the experiences with your patients? Have you had any monogamous couples in this situation who did not use condoms? Have you experienced any cases where the infected partner in a monogamous hetero relationship had VL < 1500 and transmission did occur?

The reason for my questions is that we are in this situation and wanting to have a baby...

Thanks.

Response from Dr. Holodniy

The studies would indicate that the risk of transmission is markedly diminished with lower viral loads. It is hard for me to quantify who, and how many times, the discordant couples (one positive and one negative) have had intercourse. There are clearly people in the clinic where this is happening and I have not heard any reports on transmitted infection this way. Although that does not mean infection is not happening. You don't indicate which person in the couple is positive. You may want to look into sperm washing and other techniques to further prevent infection.



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