December 23, 2009
Acute HIV infections are linked to a disproportionate share of forward transmission in certain populations, note the current study's authors. They hypothesized that patients acutely infected might be able to identify more named partners than those with established infections.
The study analyzed surveillance databases from North Carolina, which since 2002 has had an enhanced antibody/nucleic acid amplification testing program that can help differentiate recent from longstanding HIV infections. The authors identified persons age 18 and older who were diagnosed with HIV between Nov. 1, 2002 and Oct. 31, 2007, comparing the number of named sex partners by patients acutely infected (AHI) versus those with established infections (EHI). The study also compared testing among partners notified with the help of patients with AHI versus EHI.
During the period, 9,044 people were diagnosed with EHI, with AHI diagnosed for 120 others. People with AHI named 2.5 times more partners per index patient (95 percent confidence interval: 2.1 to 3.0) and 1.9 times more partners newly diagnosed with HIV per index patient (95 percent CI: 1.1 to 3.5) than patients with EHI.
"In North Carolina, persons with AHI identified proportionately more named partners and more partners newly diagnosed with HIV infections than persons with EHI," the authors concluded. "Improved detection of AHI offers critical opportunities to intervene and potentially reduce transmission of HIV."