Modelling the impact of chlamydia screening on the transmission of HIV among men who have sex with men.
Modelling the impact of chlamydia screening on the transmission of HIV among men who have sex with men.
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DOI：
10.1186/1471-2334-13-436
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发表时间：
2013-09-18
影响因子：
3.7
通讯作者：
van der Sande MA
中科院分区：
文献类型：
--
作者：
Xiridou M;Vriend HJ;Lugner AK;Wallinga J;Fennema JS;Prins JM;Geerlings SE;Rijnders BJ;Prins M;de Vries HJ;Postma MJ;van Veen MG;Schim van der Loeff MF;van der Sande MA
最近的研究发现，在感染艾滋病毒的男男性行为者(MSM)中，无症状直肠衣原体感染的发病率很高。衣原体感染可增加HIV的传染性和对HIV感染的易感性。我们调查了衣原体在男男性行为者中传播艾滋病毒的作用，以及在艾滋病毒治疗中心对感染艾滋病毒的男男性行为者进行常规衣原体筛查对整个男男性行为人群中衣原体和艾滋病毒发病率的可能影响。建立了描述HIV和衣原体在男男性接触者中传播的数学模型。与性行为相关的参数是从阿姆斯特丹MSM队列研究的数据中估计出来的。对没有置信度估计的模型参数进行了不确定度分析。研究了不同的衣原体筛查策略的效果。在所有MSM新感染的艾滋病毒中，15%可归因于衣原体感染。在定期咨询HIV期间，对感染HIV的男男性行为者每六个月进行一次常规的衣原体筛查，可以降低MSM中这两种感染的发生率：与目前的情况相比，10年后，衣原体发病率的相对百分比将下降15%，HIV发病率的相对百分比将下降4%。衣原体筛查在减少艾滋病毒发病率方面更有效，筛查频率更高，最危险的男男性接触者参与筛查计划的比例更高。衣原体感染可能是男男性接触者传播HIV的原因之一。减少衣原体流行的预防措施，例如对感染艾滋病毒的男男性同性恋者进行常规衣原体筛查，可以导致衣原体和艾滋病毒发病率的下降。
Recent studies have found high prevalences of asymptomatic rectal chlamydia among HIV-infected men who have sex with men (MSM). Chlamydia could increase the infectivity of HIV and the susceptibility to HIV infection. We investigate the role of chlamydia in the spread of HIV among MSM and the possible impact of routine chlamydia screening among HIV-infected MSM at HIV treatment centres on the incidence of chlamydia and HIV in the overall MSM population. A mathematical model was developed to describe the transmission of HIV and chlamydia among MSM. Parameters relating to sexual behaviour were estimated from data from the Amsterdam Cohort Study among MSM. Uncertainty analysis was carried out for model parameters without confident estimates. The effects of different screening strategies for chlamydia were investigated. Among all new HIV infections in MSM, 15% can be attributed to chlamydia infection. Introduction of routine chlamydia screening every six months among HIV-infected MSM during regular HIV consultations can reduce the incidence of both infections among MSM: after 10 years, the relative percentage reduction in chlamydia incidence would be 15% and in HIV incidence 4%, compared to the current situation. Chlamydia screening is more effective in reducing HIV incidence with more frequent screening and with higher participation of the most risky MSM in the screening program. Chlamydia infection could contribute to the transmission of HIV among MSM. Preventive measures reducing chlamydia prevalence, such as routine chlamydia screening of HIV-infected MSM, can result in a decline in the incidence of chlamydia and HIV.
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影响因子：
3.6
作者：
Freeman, Esther E.;Orroth, Kate K.;Hayes, Richard J.
通讯作者：
Hayes, Richard J.
DOI：
10.1097/00126334-200308150-00014
发表时间：
2003-08-15
影响因子：
3.6
作者：
Farley, TA;Cohen, DA;Besch, CL
通讯作者：
Besch, CL
影响因子：
3.3
作者：
Johnson, Leigh F.;Dorrington, Rob E.;Coetzee, David J.
通讯作者：
Coetzee, David J.
影响因子：
1.4
作者：
Drummond, F.;Ryder, N.;Donovan, B.
通讯作者：
Donovan, B.
影响因子：
3.1
作者：
Ghani, AC;Swinton, J;Garnett, GP
通讯作者：
Garnett, GP