HIV-1 transmission during recent infection and during treatment interruptions as major drivers of new infections in the Swiss HIV Cohort Study. Clinical Infectious Diseases
Marzel et al. aimed to determine the fraction of HIV-1 transmissions that occurs during recent HIV-1 infection. They found that the median fraction of transmission during recent infection (i.e., first year after seroconversion) ranged from a minimum of 41% to a maximum of 57%. HIV transmission in the chronic phase was strongly associated with higher area under the curve (AUC) of chronic-phase viral load and delayed initiation of antiretroviral therapy (ART). Additionally, at least 14% of the chronic-phase transmission events occurred after the transmitter had interrupted ART.
In conclusion, the study identified recent infections and HIV transmission during treatment interruptions as key issues for treatment as prevention and underlines the importance of early diagnosis and of early and continuous treatment.