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Chapter 2 : Features of HIV Transmission

Author: Jay A. Levy1
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Affiliations: 1: Department of Medicine, Laboratory for Tumor and AIDS Virus Research and Cancer Research Institute University of California, School of Medicine San Francisco, California
Content Type: Monograph
Publication Year: 2007

Category: Viruses and Viral Pathogenesis

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Abstract:

This chapter reviews the evidence on virus load in various body fluids and the findings are considered in relation to virus transmission. The value of anti-HIV antibodies in assessing HIV infection is discussed in this chapter. The transmission of HIV by genital fluids is more likely through virus-infected cells than free virus since cells can be present in higher numbers than free infectious virus in these body fluids. The risk of HIV transmission is increased with high levels of virus in the body fluids and the number of contacts an individual has with a body fluid. The receptive partner in sexual transmission is most at risk. In women, cells in the cervix or within the endometrium can be infected. In men and women, the infection site can involve bowel mucosal cells or lymphocytes and macrophages present in the rectum. The insertive partner may be infected by cells along the urethral canal or associated with the prepuce. Risk of HIV infection by blood depends on the level of infectious virus in this body fluid. Heating has eliminated the risk of infection from blood products. The estimated risk of HIV infection from needlestick injuries is 1 in 300 to 400, with deep injury carrying the greatest chance of infection. Risk from mucosal membrane and skin exposures is approximately 1 in 1,000 or less and is influenced by the amount of blood and viral load. Antiretroviral therapy and other preventive measures can greatly reduce the risk of mother-child transmission.

Citation: Levy J. 2007. Features of HIV Transmission, p 27-54. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch02

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Features of HIV Transmission
Citation: Levy J. 2007. Features of HIV Transmission, p 27-54. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch02
/content/10.1128/9781555815653.ch02.ch02fig01
Figure 2.1
Epidemiology of infectious diseases. A variety of host and environmental factors, as well as characteristics of the infectious agent, determine transmission of the agent and induction of disease. Reprinted from reference 3831 with permission. Copyright © 1997 Massachusetts Medical Society. All rights reserved.
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Figure 2.1

Epidemiology of infectious diseases. A variety of host and environmental factors, as well as characteristics of the infectious agent, determine transmission of the agent and induction of disease. Reprinted from reference 3831 with permission. Copyright © 1997 Massachusetts Medical Society. All rights reserved.

Citation: Levy J. 2007. Features of HIV Transmission, p 27-54. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch02
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Figure 2.2
Schematic representation of the reverse transcriptase PCR and branched-chain DNA techniques for amplification and quantitation of viral RNA in blood and body fluids. Adapted from reference 1707 with permission.
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Figure 2.2

Schematic representation of the reverse transcriptase PCR and branched-chain DNA techniques for amplification and quantitation of viral RNA in blood and body fluids. Adapted from reference 1707 with permission.

Citation: Levy J. 2007. Features of HIV Transmission, p 27-54. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch02
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Figure 2.3
Many cell types can bind HIV directly through specific cell surface receptors (e.g., DC-SIGN) or via attachment of HIV immune complexes to cellular receptors (e.g., CD21 and CD35). Infectious virus can then be transferred to various target cells. Reproduced from (2530), copyright 2002, with permission from Elsevier.
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Figure 2.3

Many cell types can bind HIV directly through specific cell surface receptors (e.g., DC-SIGN) or via attachment of HIV immune complexes to cellular receptors (e.g., CD21 and CD35). Infectious virus can then be transferred to various target cells. Reproduced from (2530), copyright 2002, with permission from Elsevier.

Citation: Levy J. 2007. Features of HIV Transmission, p 27-54. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch02
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Figure 2.4
HIV-infected cells detected in seminal fluid by in situ hybridization. Magnification, × 40. Reprinted from reference 2517 with permission. Copyright © 1988, American Medical Association. All rights reserved.
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Figure 2.4

HIV-infected cells detected in seminal fluid by in situ hybridization. Magnification, × 40. Reprinted from reference 2517 with permission. Copyright © 1988, American Medical Association. All rights reserved.

Citation: Levy J. 2007. Features of HIV Transmission, p 27-54. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch02
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Figure 2.5
HIV-infected HUT 78 T cell (top) cocultivated for 1 h with an ME180 cervix-derived epithelial cell (bottom). Virus can be seen at the cell-cell interface (4375). It is noteworthy that virus is produced by the T-cell line only at the point of contact with the epithelial cells. A role for cytokines in this localized induction of virus production should be considered (see text). Magnification, × 10,000. Photomicrograph provided by D. Phillips.
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Image of Figure 2.5
Figure 2.5

HIV-infected HUT 78 T cell (top) cocultivated for 1 h with an ME180 cervix-derived epithelial cell (bottom). Virus can be seen at the cell-cell interface (4375). It is noteworthy that virus is produced by the T-cell line only at the point of contact with the epithelial cells. A role for cytokines in this localized induction of virus production should be considered (see text). Magnification, × 10,000. Photomicrograph provided by D. Phillips.

Citation: Levy J. 2007. Features of HIV Transmission, p 27-54. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch02
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Figure 2.6
Interconnected factors that influence the sexual spread of HIV. Adapted from reference 2883 with permission.
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Figure 2.6

Interconnected factors that influence the sexual spread of HIV. Adapted from reference 2883 with permission.

Citation: Levy J. 2007. Features of HIV Transmission, p 27-54. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch02
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Figure 2.7
Transmission electron micrograph of HIV-infected U937 cells 3 h after addition to the I-407 intestinal epithelial cell line. Virus particles can be observed between the monocyte and the epithelial cell surface in the area of contact. Magnification, × 14,000. Reprinted with permission from reference 467. Photomicrograph provided by D. Phillips.
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Image of Figure 2.7
Figure 2.7

Transmission electron micrograph of HIV-infected U937 cells 3 h after addition to the I-407 intestinal epithelial cell line. Virus particles can be observed between the monocyte and the epithelial cell surface in the area of contact. Magnification, × 14,000. Reprinted with permission from reference 467. Photomicrograph provided by D. Phillips.

Citation: Levy J. 2007. Features of HIV Transmission, p 27-54. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch02
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References

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Tables

Features of HIV Transmission
Citation: Levy J. 2007. Features of HIV Transmission, p 27-54. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch02
/content/10.1128/9781555815653.ch02.ch02tab01
Table 2.1
Isolation of HIV from body fluids
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Table 2.1

Isolation of HIV from body fluids

Citation: Levy J. 2007. Features of HIV Transmission, p 27-54. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch02
/content/10.1128/9781555815653.ch02.ch02tab02
Table 2.2
Titer of infectious HIV-1 recovered from plasma in relation to CD4 cell count
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Table 2.2

Titer of infectious HIV-1 recovered from plasma in relation to CD4 cell count

Citation: Levy J. 2007. Features of HIV Transmission, p 27-54. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch02
/content/10.1128/9781555815653.ch02.ch02tab03
Table 2.3
Plasma viremia and clinical stage
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Table 2.3

Plasma viremia and clinical stage

Citation: Levy J. 2007. Features of HIV Transmission, p 27-54. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch02
/content/10.1128/9781555815653.ch02.ch02tab04
Table 2.4
HIV pathogenesis: importance of the virus-infected cell
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Table 2.4

HIV pathogenesis: importance of the virus-infected cell

Citation: Levy J. 2007. Features of HIV Transmission, p 27-54. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch02
/content/10.1128/9781555815653.ch02.ch02tab05
Table 2.5
Factors affecting HIV-1 shedding in the genital tract
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Table 2.5

Factors affecting HIV-1 shedding in the genital tract

Citation: Levy J. 2007. Features of HIV Transmission, p 27-54. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch02
/content/10.1128/9781555815653.ch02.ch02tab06
Table 2.6
Estimates of risk of HIV transmission and global importance
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Table 2.6

Estimates of risk of HIV transmission and global importance

Citation: Levy J. 2007. Features of HIV Transmission, p 27-54. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch02
/content/10.1128/9781555815653.ch02.ch02tab07
Table 2.7
Factors associated with mother-child transmission
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Table 2.7

Factors associated with mother-child transmission

Citation: Levy J. 2007. Features of HIV Transmission, p 27-54. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch02
/content/10.1128/9781555815653.ch02.ch02tab08
Table 2.8
Evidence for in utero, intrapartum, and breast feeding transmission of HIV-1
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Table 2.8

Evidence for in utero, intrapartum, and breast feeding transmission of HIV-1

Citation: Levy J. 2007. Features of HIV Transmission, p 27-54. In HIV and the Pathogenesis of AIDS, Third Edition. ASM Press, Washington, DC. doi: 10.1128/9781555815653.ch02

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