ArticleAIDS (London, England)2013
Have the explosive HIV epidemics in sub-Saharan Africa been driven by higher community viral load?
Article in AIDS (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Global population-level association between herpes simplex virus 2 prevalence and HIV prevalence.AIDS (London, England) · 2018Pooled it
- Identification of antibody targets associated with lower HIV viral load and viremic control.PloS one · 2024Trial
- Evaluation of viral suppression and medication-related burden among HIV-infected adults in a secondary care facility.Exploratory research in clinical and social pharmacy · 2024Article
- Alcohol use, intimate partner violence, and HIV sexual risk behavior among young people in fishing communities of Lake Victoria, Uganda.BMC public health · 2021Article
- Spatial patterns and associated factors of HIV Seropositivity among adults in Ethiopia from EDHS 2016: a spatial and multilevel analysis.BMC infectious diseases · 2020Article
- Reduction in HIV community viral loads following the implementation of a "Treatment as Prevention" strategy over 2 years at a population-level among men who have sex with men in Hangzhou, China.BMC infectious diseases · 2018Article
- Modelling the dynamics of population viral load measures under HIV treatment as prevention.Infectious Disease Modelling · 2018Article
- Experiences and expectations of patients living with HIV on their engagement with care in Western Kenya.Patient preference and adherence · 2018Article
- The HIV-1 transmission bottleneck.Retrovirology · 2017Article
- Nonpaternity and Half-Siblingships as Objective Measures of Extramarital Sex: Mathematical Modeling and Simulations.BioMed research international · 2017Article
- What explains gender inequalities in HIV/AIDS prevalence in sub-Saharan Africa? Evidence from the demographic and health surveys.BMC public health · 2016Article
- Weak signal detection: A discrete window of opportunity for achieving 'Vision 90:90:90'?SAHARA J : journal of Social Aspects of HIV/AIDS Research Alliance · 2016Article
- Expanding the prevention armamentarium portfolio: a framework for promoting HIV-Conversant Communities within a complex, adaptive epidemiological landscape.SAHARA J : journal of Social Aspects of HIV/AIDS Research Alliance · 2015Article
- How does population viral load vary with the evolution of a large HIV epidemic in sub-Saharan Africa?AIDS (London, England) · 2014Article
- Virulence and pathogenesis of HIV-1 infection: an evolutionary perspective.Science (New York, N.Y.) · 2014Review
- Sources of HIV incidence among stable couples in sub-Saharan Africa.Journal of the International AIDS Society · 2014Article
- Mapping HIV clustering: a strategy for identifying populations at high risk of HIV infection in sub-Saharan Africa.International journal of health geographics · 2013Article
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8 authors.
Funding
Abstract
objectiveThe HIV epidemic has carved contrasting trajectories around the world with sub-Saharan Africa (SSA) being most affected. We hypothesized that mean HIV-1 plasma RNA viral loads are higher in SSA than other areas, and that these elevated levels may contribute to the scale of epidemics in this region. DESIGN AND
methodsTo evaluate this hypothesis, we constructed a database of means of 71,668 viral load measurements from 44 cohorts in seven regions of the world. We used linear regression statistical models to estimate differences in viral load between regions. We also constructed and analyzed a mathematical model to describe the impact of the regional viral load differences on HIV epidemic trajectory.
resultsWe found substantial regional viral load heterogeneity. The mean viral load in SSA was 0.58 log(10) copies/ml higher than in North America (95% confidence interval 0.45-0.71); this represents about a four-fold increase. The highest mean viral loads were found in Southern and East Africa, whereas in Asia, Europe, North America, and South America, mean viral loads were comparable. Mathematical modeling indicated that conservatively 14% of HIV infections in a representative population in Kenya could be attributed to the enhanced infectiousness of patients with heightened viral load.
conclusionWe conclude that community viral load appears to be higher in SSA than in other regions and this may be a central driver of the massive HIV epidemics in this region. The elevated viral loads in SSA may reflect, among other factors, the high burden of co-infections or the preponderance of HIV-1 subtype C infection.
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