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PHealthy t1_j8id89r wrote

A few things to clear up:

HIV has a strong tropism for CD4+ cells so provirus integration within egg and sperm cells is fairly rare but can occur preconception:

The Integrated HIV-1 Provirus in Patient Sperm Chromosome and Its Transfer into the Early Embryo by Fertilization

When it comes to perinatal HIV infection, there are many other available modes of vertical transmission: breastfeeding, placenta, etc.... Children that don't receive ART typically don't live past 2 years old:

Prevention of vertical transmission of HIV-1 in resource-limited settings

So this more traditional transmission method can obfuscate the origin of HIV. But even then, the risk for vertical transmission is between 15% and 45%.

All this means that there are indeed plenty of mechanisms to transmit HIV perinatally but that doesn't mean it is an absolute certainty .

If anyone is interested in infectious disease news: r/ID_News

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MammothBobcat251 t1_j8j7u5n wrote

Question. If the mother is vitally suppressed during pregnancy does that reduce the risk of vertical transmission or does the constant connection between mother and child in the womb counteract that process?

Great response btw.

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PHealthy t1_j8jdai3 wrote

Most studies just use ART usage as a proxy for viral load but it makes a huge (>90%) risk reduction.

https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(22)00289-2/fulltext

https://onlinelibrary.wiley.com/doi/10.1111/hiv.12397

https://www.frontiersin.org/articles/10.3389/fpubh.2019.00401/full

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MammothBobcat251 t1_j8jfsjj wrote

Thank you for the clarification on those being numbers for people whose viral load is not suppressed. And the data.

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