Lack of Effectiveness of Antiretroviral Therapy in Preventing HIV Infection in Serodiscordant Couples in Uganda: An Observational Study

• DOI: 10.1371/journal.pone.0132182
• Publication Date: 2015-07-14T18:01:49Z
• Authors: Josephine Birungi; Jeong Eun Min; Katherine A. Muldoon; Pontiano Kaleebu; Rachel King; Sarah Khanakwa; Maureen Nyonyintono; YaLin Chen; Edward J. Mills; Fred Lyagoba; Manon Ragonnet-Cr...; Jonathan Wangisi; Lillian Lourenco; David M. Moore
• Keywords: Serodiscordant; Seroconversion

Background We examined the real-world effectiveness of ART as an HIV prevention tool among serodiscordant couples in a programmatic setting low-income country. Methods enrolled individuals from aged ≥18 years age Jinja, Uganda June 2009 – 2011. In one group positive partner was receiving they met clinical eligibility criteria (a CD4 cell count ≤250 cells/ μL or WHO Stage III/IV disease). second infected not yet ART-eligible. measured incidence by testing uninfected every three months. conducted genetic linkage studies to determine source new infections seroconverting participants. Results A total 586 were which 249 (42%) participants at enrollment, and additional 99 (17%) initiated during study. The median duration follow-up 1.5 years. found 9 partners who had been for least months 8 received it less than months, rates 2.09 per 100 person-years (PYRs) 2.30 PYRs, respectively. rate ratio ART-use 0.91 (95% confidence interval 0.31-2.70; p=0.999). hazard seroconversion associated with 1.07 CI 0.41-2.80). 5/7 (71%) transmissions on 6/7 (86%) those genetically linked. Conclusion Overall low comparison previous couples. However, reduced risk transmission this