This article is more than 5 years old. Information may no longer be current.
Community viral load may track HIV/AIDS epidemic, lead to targeted interventions
Click Here to Manage Email Alerts
BOSTON — Mean and total community viral load may aid in the assessment of trends in HIV/AIDS epidemics and may therefore serve as a novel tool in assessing the potential impact of HIV prevention interventions at the population level, Amanda Castel, MD, MPH, said during a presentation here.
Previous findings have indicated that community viral load may be a successful biomarker for assessing HIV transmission at the population level and may lead to a decreased incidence for HIV.
For this reason, Castel, assistant professor in the department of epidemiology and biostatistics at George Washington University School of Public Health and Health Services, and colleagues at the D.C. Department of Health HIV/AIDS, Hepatitis, STD, Tuberculosis Administration set out to assess the trends in community viral load in Washington D.C. between 2004 and 2008.
Possible variations by subgroup were determined and the association between the geographic distribution of community viral load and socioeconomic status were assessed for 15,693 HIV cases reported to the Washington D.C. HIV/AIDS surveillance database; 48.1% had at least one viral load report.
The majority with viral load data were black, male, infected by male-to-male sexual contact, has AIDS and resided in impoverished areas of the city, according to Castel.
Mean and overall community viral load were 55,879 copies/mL and 422,176,120 copies/mL, respectively. The highest mean viral load occurred most often in females, blacks and those infected heterosexually.
During the 5-year study period, increases were found in overall community viral load (P<.001). Conversely, mean community viral load decreased significantly (P<.001). Areas with the highest unemployment and poverty rates, and the lowest proportion of high school graduates had the highest mean community viral load.
“Our findings suggest that Washington D.C.’s mean viral load is higher than other jurisdictions, but are consistent with Washington D.C.’s HIV/AIDS surveillance and epidemiological data which reflect a severe and generalized epidemic,” she said. “The completeness of viral load data will improve over time with improved electronic lab recording. However, at this point, this methodology can be used to track the epidemic, develop targeted interventions in high viral load areas and to monitor the impact of these interventions.” – by Jennifer Henry
For more information:
- Castel A. #1023. Presented at: 18th Conference on Retroviruses and Opportunistic Infections; Feb. 27-March 3, 2011; Boston.
[This] important presentation is trying to address the health of the entire community in the same way that individual viral loads are used to assess the health of individuals. These are levels across communities that might give us some insight into where we still have substantial disparities and where we need to intervene more aggressively as well as to potentially look at where the vulnerable points for transmission exist. The one caveat being that people who are unaware that they are HIV positive are not even included in these estimates.
– Susan Buchbinder, MD
San Francisco
Department of Public Health
 |
Follow InfectiousDiseaseNews.com on Twitter. |