The Biology of HIV Transmission
The Biology of HIV Transmission
The purpose of this study is to look at the amount of HIV in the blood, genital fluid, and
 saliva of the partners of patients with early HIV infection. This study will also look at the
 strength of the immune systems of patients with early HIV infection.

 Because HIV multiplies very quickly in the early stages of infection, patients with early HIV
 infection may be more likely to transmit HIV to their partners. The amount of HIV in blood,
 genital fluid, and saliva may determine the risk for transmission.
Persons with early HIV infection may represent high transmission risk to their partners.
 Early infection, characterized by rapid virologic replication, insufficient immunologic
 control of infection, and more rapid course of disease progression, may be associated with
 increased infectiousness. The viral determinants of transmission may in part be explained by
 viral burden in blood, genital fluids, and oral cavity fluids. All three fluids may be the
 source for transmitted virus.

 Persons with suspected HIV infection are asked to identify their possible source partners.
 The importance of partner referral is emphasized and assisted recruitment or active tracing
 is offered if necessary. Source partners will not be approached uninvited. If a partner
 states that he/she does not want to be contacted, then he/she will not be contacted further
 for the purpose of this study or for any other study. All patients are offered HIV counseling
 and plasma testing for HIV-1 RNA and CD4+ cells. Blood specimens are collected for plasma
 determination, and cellular and plasma fractions are collected for CAF and neutralization
 antibodies. Neutralization assays are used to detect humoral immune response in patients with
 primary HIV infection. Genital fluids and saliva are analyzed for viral RNA. Patients are
 seen in the clinic on Day 1 for blood draw and return 2 weeks later for blood test results. A
 follow-up period of at least 4 weeks is planned. Compensation is provided to all patients.
Inclusion Criteria

 Patients may be eligible for this study if they:

 -  Are at least 18 years old.

 -  Have sex with or share injection drugs with a person who is thought to have early HIV
 infection, or if they have recently become HIV-positive.

 -  Can provide written consent.

 -  Are available for a follow-up period of at least 4 weeks.