       Document 0004
 DOCN  M94A0004
 TI    Antiretroviral treatment of men infected with human immunodeficiency
       virus type 1 reduces the incidence of heterosexual transmission. Italian
       Study Group on HIV Heterosexual Transmission.
 DT    9412
 AU    Musicco M; Lazzarin A; Nicolosi A; Gasparini M; Costigliola P; Arici C;
       Saracco A; National Research Council, University of Milano, Italy.
 SO    Arch Intern Med. 1994 Sep 12;154(17):1971-6. Unique Identifier :
       AIDSLINE MED/94354740
 AB    OBJECTIVE: To determine the incidence of heterosexual human
       immunodeficiency virus type 1 disease transmission and the effect of
       zidovudine therapy on this risk of transmission. DESIGN: A cohort of 436
       monogamous seronegative female sexual partners of human immunodeficiency
       virus type 1-infected males was followed up for 740 person-years with
       regular structured interviews and laboratory tests. PATIENTS: At
       enrollment of the women, 50% of their infected partners had one or more
       signs of disease progression (symptoms of acquired immunodeficiency
       syndrome, p24 antigen positivity, or CD4+ cell counts lower than 0.4 x
       10(9)/L) and 15% were treated with zidovudine. MAIN OUTCOME MEASURE:
       Incidence rates of seroconversion were calculated and relative risks
       were estimated as incidence rate ratios. RESULTS: Twenty-seven women
       seroconverted during follow-up, and the incidence of seroconversion was
       3.7 per 100 person-years. Seroconversion was about six times more
       frequent (relative risk, 5.8; 95% confidence interval, 2.2 to 15.3) in
       couples not using condoms. Men with signs of disease progression
       transmitted infection to their partners more frequently and were more
       frequently treated with zidovudine. When the risk of transmission was
       estimated accounting for disease progression, the rate of transmission
       in zidovudine-treated men was lower than in untreated men (relative
       risk, 0.5; 95% confidence interval, 0.1 to 0.9). CONCLUSION: Treatment
       of human immunodeficiency virus type-1 infected men with zidovudine
       reduces, but does not eliminate, heterosexual transmission of infection.
       Behavioral counseling that encourages sexual practices with a lower risk
       of transmission remains the most important method of prevention.
 DE    Acquired Immunodeficiency Syndrome/*DRUG THERAPY/EPIDEMIOLOGY/
       *TRANSMISSION  Cohort Studies  Confounding Factors (Epidemiology)
       Female  Human  HIV Seronegativity  *HIV-1  Incidence  Male  *Sex
       Behavior  Sexual Partners  Sexually Transmitted Diseases,
       Viral/EPIDEMIOLOGY/*TRANSMISSION  Support, Non-U.S. Gov't
       Zidovudine/*THERAPEUTIC USE  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

