The spread, treatment, and prevention of HIV-1: evolution of a global pandemic
Myron S. Cohen, … , Kevin DeCock, Joep Lange
Myron S. Cohen, … , Kevin DeCock, Joep Lange
Published April 1, 2008
Citation Information: J Clin Invest. 2008;118(4):1244-1254. https://doi.org/10.1172/JCI34706.
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The spread, treatment, and prevention of HIV-1: evolution of a global pandemic

Abstract

The most up-to-date estimates demonstrate very heterogeneous spread of HIV-1, and more than 30 million people are now living with HIV-1 infection, most of them in sub-Saharan Africa. The efficiency of transmission of HIV-1 depends primarily on the concentration of the virus in the infectious host. Although treatment with antiviral agents has proven a very effective way to improve the health and survival of infected individuals, as we discuss here, the epidemic will continue to grow unless greatly improved prevention strategies can be developed and implemented. No prophylactic vaccine is on the horizon. However, several behavioral and structural strategies have made a difference — male circumcision provides substantial protection from sexually transmitted diseases, including HIV-1, and the application of antiretroviral agents for prevention holds great promise.

Authors

Myron S. Cohen, Nick Hellmann, Jay A. Levy, Kevin DeCock, Joep Lange

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Figure 2

HIV-1 viremia and HIV-1 shedding over time.

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HIV-1 viremia and HIV-1 shedding over time. The concentration of HIV-1 i...
The concentration of HIV-1 in blood and genital secretions varies dramatically depending on the stage of the disease. Shown here are data for HIV-1 viremia and HIV-1 shedding over time in men acutely or chronically infected with HIV-1. Measurements of HIV-1 RNA in blood plasma (gray) and seminal plasma (black) are displayed over 16 weeks. The data were generated from 16 acutely infected subjects, who contributed blood and semen at 60 and 34 time points, respectively, and from 25 chronically infected subjects, who contributed blood and semen at 123 and 89 time points, respectively. The highest viral loads were detected at the first time point after infection and in people with advanced disease. Boxes and whiskers denote the 25th and 75th quartiles and total range of values. Internal circles and horizontal lines represent mean and median, respectively. Reproduced with permission from AIDS (15).