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. 2015 Mar 11;68(5):594–598. doi: 10.1097/QAI.0000000000000511

FIGURE 1.

FIGURE 1

Schematic diagram illustrating the estimated impact of HIV-1 coinfections that increase HIV-1 PVL on (A) set-point PVL, (B) duration of asymptomatic HIV-1 infection, (C) HIV-1 transmission rate (hazard of transmission: probability of HIV-1 transmission per year), and (D) HIV-1 transmission potential (product of hazard of transmission and duration of asymptomatic infection) for 2 hypothetical patients. Time starts at the beginning of each individual's asymptomatic period (ie, after high PVL accompanying primary infection). The individual with lower set-point PVL has a correspondingly longer duration of asymptomatic infection (A). The figure shows that all patients experiencing an increase in PVL as a result of coinfection would experience decreases in duration of asymptomatic infection and increases in HIV-1 infectiousness, but the direction of change to transmission potential depends on baseline set-point PVL and the amount that PVL is augmented on coinfection. See Baggaley et al7 for further explanation. The frequency distribution of set-point PVLs used in the analysis, based on a model fit27 to data from Orange County, South Africa,16 is shown in gray in (B–D) and shows that HIV-1–infected individuals with set-point PVLs typical of South Africa could have an increase or decrease in transmission potential as a result of modest decrease in PVL.