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Thomas R. O'Brien, MD, MPH
National Cancer Institute Rockville, Md

JAMA. 1994;271(12):903-904.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Dr De Cock and colleagues¹ summarize data suggesting that human immunodeficiency virus type 2 (HIV2) is less transmissible through sexual intercourse than HIV-1 and conclude that this difference explains the more limited global spread of HIV-2. The authors postulate that the lesser infectivity of HIV-2 is attributable to a relatively lower viral load (and presumably lower levels of virus in semen and female genital secretions) in HIV-2—infected persons with high CD4⁺ lymphocyte counts compared with HIV-1—infected persons with similar values. The authors also suggest that HIV-2 may be less transmissible because late-stage disease, a period of increased viral load, develops more slowly with HIV-2 infection than with HIV-1. However, the natural history and transmissibility of these retroviruses may be linked by at least two additional factors.

First, quantitative studies of HIV-1—infected persons have shown high viral levels during primary infection,² and statistical models suggest that . . . [Full Text PDF of this Article]

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