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High Viral Load Levels in Young People Newly Linked With HIV Care in the U.S.

January 8, 2014

This article was reported by NAM aidsmap.

An article in NAM aidsmap reported on a new study, published in the journal "AIDS," that showed young men who have sex with men (MSM) have viral loads that point to a high transmission rate. Researchers found that the mean viral load of young MSM, approximately 125,000 copies per milliliter (ml), was significantly higher than the typical 47,000 copies/ml found in their heterosexual counterparts.

Study authors noted that these high viral loads could be attributed to the reality that young people are diagnosed closer to the time of infection, when viral loads are extremely high, whereas many adults are diagnosed later, when viral loads have declined already. Late diagnosis is a factor of HIV-related sickness and death in the United States. Health experts emphasize the importance of early diagnosis and care to assist persons in living longer, healthier lives, as well as lowering the transmission rate. Low viral loads through antiretroviral therapy greatly reduce the risk of transmitting the virus to sexual partners. A "test and treat" approach is urged as a way of controlling the epidemic.

The study looked at HIV cases in youth between 12 and 24 years old who were associated with seeking HIV care in 2010-2011. One-fourth of new US HIV diagnoses are youth between 13 and 24 years old, with 87 percent of them occurring among young MSM. Researchers analyzed medical records of 1,409 people linked to HIV care at 15 US sites, out of which they found 852 people who had both CD4 and viral load results and were eligible for inclusion in the study.

Sexuality and mode of transmission both were associated with viral load, with significantly higher rates in MSM and homosexual sex compared to heterosexual sex or mother-to-child transmission. "Our findings suggest that the population of HIV-infected youth may be a highly infectious population," the authors wrote, which they admit may be due to prompt diagnosis. "As supported by our higher CD4 cell counts and proportions with CD4 cell count more than 350 (over 2/3) compared with adults (43%), youth are more likely diagnosed closer to their time of infection than adults and, therefore, viral dynamics may skew viral load data."

The full report, "HIV Viral Load Levels and CD4+ Cell Counts of Youth in 14 US Cities," was published online in the journal AIDS (2013; doi: 10.1097/QAD.0000000000000183).

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