Posted on Jan 21, 2019, 10 p.m.
Bodies of clinical evidence have established that HIV Undetectable=Untransmittable (U=U) concept is scientifically sound, U=U means that those living with HIV that have achieved and maintained an undetectable viral load of HIV in the blood by taking and adhering to antiretroviral therapy as prescribed will not sexually transmit the virus to others.
Officials from National Institute of Health/National Institute of Allergy and Infectious Disease have reviewed scientific evidence underlying the Undetectable=Untransmittable concept, and have discussed implications of the widespread acceptance of this message, the new commentary has been published in JAMA.
The officials summarize results from large scale clinical trials and cohort studies validating Undetectable=Untransmittable. NIH funded clinical trials showed no linked HIV transmissions occurring among participating HIV serodifferent heterosexual couples when the partner with HIV had durably suppressed the viral load; these finding were confirmed by the PARTNER and Opposite Attract studies which also extended findings into same sex male couples.
Acceptance of the U=U concept as scientifically sound has several behavioral, social, and legal implications, and as the NIAID officials note also validates HIV treatment as a prevention strategy, as U=U may help to control the HIV pandemic by preventing HIV transmission and may also help to reduce the stigma that many with HIV face.
Success of Undetectable=Untransmittable depends totally upon achieving and maintaining an undetectable HIV viral load by taking antiretroviral therapy daily as prescribed and adhering to the schedule strictly and continuously. Numerous factors such as lack of access to quality healthcare can make it difficult to adhere to antiretroviral therapy as prescribed. Implementing programs designed to help HIV patients remain in care and address the barriers to daily therapy remain important, and were emphasized by the officials in order to enhance overall success of the Undetectable=Untransmittable concept.
Materials provided by NIH/National Institute of Allergy and Infectious Diseases.
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Robert W. Eisinger, Carl W. Dieffenbach, Anthony S. Fauci. HIV Viral Load and Transmissibility of HIV Infection. JAMA, 2019; DOI: 10.1001/jama.2018.21167