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Laboratory evaluation of HIV discordant heterosexual couples: a report from the HIV heterosexual transmission study.
Denny TN; Crenshaw K; Monel R; Scolpino A; Perez G; Sheffett A; Skurnick
December 30, 1992
Int Conf AIDS. 1992 Jul 19-24;8(2):C301 (abstract no. PoC 4340). Unique

OBJECTIVE: To determine the immunological and virologic status of sexually active HIV discordant couples at enrollment into a heterosexual transmission study. METHODS: The HIV infected members of the discordant couples were evaluated using HIV Ab., p24 Ag, HIV culture, plasma viremia and immune subsets. Assessment of the HIV sero-negative partner included HIV antibody, p24 Ag and immune subsets. RESULTS: Sixty HIV discordant couples were available for evaluation (HIV+: male = 51, female = 9). The median length of the couples relationship was 6 years. The mean frequency of vaginal sex (VS) for the couples in the year prior to learning the status of the index case was 3 times/week. The couples' mean frequency of VS after knowledge of the index cases antibody status was 3 times/month. Prior to learning the HIV status of the index cases, 80% of the couples denied use of condoms; 61% used condoms after learning the infectious status of their partner. The virologic status of the index cases were: HIV Ab. 60/60 Pos. (100%); p24 Ag 7/47 Pos. (17.5%). When p24 Ag was evaluated based on the number of CD4 cells, 25% of those patients with less than 500/mm3 were p24 Ag. Pos. HIV culture yielded 29/53 Pos (54.7%). When the CD4 cells were less than 500/mm3 64% were culture Pos. In patients with a CD4 of less than 200/mm3, the incidence of a Pos culture increased to 80%. Other plasma virus cultures yielded 5/55 Pos (9%). When CD4 cells were less than 500/mm3, 16% were Pos. Means +/- SD for immune subsets/mm3 were: CD3+ = 1787 +/- 748, CD4+ = 566 +/- 323, and CD8+ = 1294 +/- 601. Virologic status of the reported negative (Neg) partner was HIV Ab. 60/60 Neg. (100%) and p24 Ag 60/60 Neg. (100%). Means +/- SD for immune subsets/mm3 were: CD3+ = 2015 +/- 524, CD4+ = 1359 +/- 330, and CD8+ = 825 +/- 295. SUMMARY: Our study of heterosexual HIV discordant couples demonstrates that 39% of the sexually active couples did not use condoms. Laboratory studies conducted defined HIV infected individuals with advanced disease (less than 200 CD4+ cells/mm3) and high viral burden (ie positive plasma or blood HIV culture) who may be more prone to transmit HIV. The behavior patterns and abnormal laboratory parameters characterize couples who should provide needed insight into factors related to heterosexual HIV transmission.

AIDS Serodiagnosis Contraceptive Devices, Male CD4-CD8 Ratio Female Human HIV Core Protein p24/ISOLATION & PURIF HIV Infections/*TRANSMISSION HIV Seropositivity/*IMMUNOLOGY Male *Sex Behavior *Sexual Partners Support, U.S. Gov't, P.H.S. ABSTRACT