Viral burden in genital secretions determines male-to-female sexual transmission of HIV-1: a probabilistic empiric model
Viral burden in genital secretions determines male-to-female sexual transmission of HIV-1: a probabilistic empiric model
复制标题
DOI：
10.1097/00002030-200103300-00012
复制
发表时间：
2001-03-30
期刊：
影响因子：
3.8
通讯作者：
Cohen, MS
中科院分区：
文献类型：
--
作者：
Chakraborty, H;Sen, PK;Cohen, MS
目的：建立一种预测HIV-1男性向女性传播的模型。设计：将精浆中的HIV-1和宫颈内CCR5受体与HIV-1传播的流行病学研究相关联，建立一个概率模型。地点：精液样本采集于西雅图、华盛顿、教堂山、北卡罗来纳和瑞士圣加仑的患者。宫颈活检标本来自伊利诺伊州芝加哥市的妇女。参与者：86名可获得CD4细胞计数和精液量的男性（未接受抗病毒治疗）和24名确定宫颈内CCR5受体数量的女性。主要结局指标：根据HIV绝对负担（体积x HIV RNA拷贝数/ml精浆）预测每次阴道性交中男性向女性传播HIV-1的情况。结果：该模型表明，当精液病毒载量高时，HIV-1的异性传播效率高。当精液中含有10万份非合胞诱导（NSI） HIV RNA时，HIV-1传播的概率为每100次性交中有1次；相反，如果精液中有1000份NSI HIV RNA，传播概率为每10000次性交中有3次。结论：该模型将与异性恋HIV-1传播相关的生物学和流行病学数据联系起来。该模型可用于估计因炎症或抗逆转录病毒治疗后负担减轻的精液病毒负担高的男性的艾滋病毒传播。这一结果为艾滋病毒在一些地区的流行程度提供了生物学上的解释，在这些地区，早期的研究表明，男性的精液病毒载量很高，比如撒哈拉以南非洲。该模型可用于开发和测试HIV-1预防策略。(C) 2001 Lippincott Williams & Wilkins。
Objective: To develop a model to predict transmission of HIV-1 from men to women.Design: HIV-1 in seminal plasma, and endocervical CCR5 receptors were correlated with epidemiological studies of HIV-1 transmission to develop a probabilistic model.Settings: Semen samples were collected from patient subjects in Seattle Washington, Chapel Hill, North Carolina, and St. Gallen, Switzerland. Endocervical biopsy specimens were obtained from women in Chicago, Illinois.Participants: Eighty-six men (not receiving antireroviral therapy) in whom CD4 cell count and semen volume were available, and 24 women in whom the number of endocervical CCR5 receptors were determined.Main outcome measures: Prediction of transmission of HIV-1 from men to women per episode of vaginal intercourse based on the absolute burden of HIV (volume x HIV RNA copies/ml seminal plasma).Results: The model suggests efficient heterosexual transmission of HIV-1 when semen viral burden is high. When semen contains 1 00 000 copies of non-syncytium-inducing (NSI) HIV RNA the probability of HIV-1 transmission is 1 per 100 episodes of intercourse; conversely, with 1000 copies NSI HIV RNA in semen, transmission probability is 3 per 10 000 episodes of intercourse.Conclusions: This model links biological and epidemiological data related to heterosexual HIV-1 transmission. The model can be used to estimate transmission of HIV from men with high semen viral burden from inflammation, or reduced burden after antiretroviral therapy. The results offer a biological explanation for the magnitude of the HIV epidemic in places where earlier studies have shown men have high semen viral burden, such as in sub-Saharan Africa. The model can be used to develop and test HIV-1 prevention strategies. (C) 2001 Lippincott Williams & Wilkins.