HIV-infected people with a lower amount of the virus in their blood have the potential to infect more people than those with a high viral load, say Dutch and British scientists who analyzed data from untreated groups of people infected with HIV in Holland, Uganda and Zambia.
Scientists found that people with an intermediate viral load - typical of the asymptomatic stage after infection and before the onset of AIDS - have a better prognosis and hence more opportunity to transmit the virus to others before they progress to AIDS.
"The public health implications are staggering," says Thumbi Ndung'u of the University of KwaZulu-Natal's Nelson Mandela School of Medicine in South Africa.
"We may have to treat massive numbers of asymptomatic HIV infected individuals not previously thought to require treatment," Ndung'u told SciDev.Net, adding the new findings could lead to a paradigm shift in the way in which public health practitioners view asymptomatic chronic HIV infection.
The study, published for the Oct. 22 issue of the National Academy of Sciences, conclude that targeting antiretroviral therapy at people with the highest HIV viral loads, even though they are likely to have the most severe infection, is "misguided."
