Role of acute and early HIV infection in the sexual transmission of HIV.
Role of acute and early HIV infection in the sexual transmission of HIV.
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DOI：
10.1097/coh.0b013e32833a0d3a
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发表时间：
2010-07
影响因子：
4.1
通讯作者：
Powers KA
中科院分区：
文献类型：
--
作者：
Miller WC;Rosenberg NE;Rutstein SE;Powers KA
急性HIV感染（AHI）是HIV感染后最早的阶段，持续时间只有几周。在这短暂的时期内，血液和生殖器分泌物中的艾滋病毒浓度极高，增加了艾滋病毒传播的可能性。尽管AHI在HIV性传播中的重要作用在生物学上是可信的，但AHI在HIV流行病学传播中的意义仍不确定。AHI是通过检测HIV血清阴性患者血液中的病毒RNA或抗原来诊断的。根据环境的不同，AHI患者占新诊断的艾滋病毒感染者的1%至10%。AHI期间的高浓度病毒导致传染性增加，可能比慢性感染期间高26倍。在数学模型中，根据模型结构、模型参数和种群的不同，AHI传播的估计比例变化很大。关键决定因素包括艾滋病毒流行的阶段和人口的性风险状况。尽管AHI持续时间短，但它在HIV感染的性传播中起着不成比例的作用。检测AHI患者可能为预防传播提供重要机会。
Acute HIV infection (AHI), the earliest period after HIV acquisition, is only a few weeks in duration. In this brief period, the concentration of HIV in blood and genital secretions is extremely high, increasing the probability of HIV transmission. Although a substantial role of AHI in the sexual transmission of HIV is biologically plausible, the significance of AHI in the epidemiological spread of HIV remains uncertain. AHI is diagnosed by detecting viral RNA or antigen in the blood of persons who are HIV seronegative. Depending on the setting, persons with AHI represent between 1% and 10% of persons with newly diagnosed HIV infection. The high concentration of virus during AHI leads to increased infectiousness, possibly as much as 26 times greater than during chronic infection. In mathematical models, the estimated proportion of transmission attributed to AHI has varied considerably, depending on model structure, model parameters and the population. Key determinants include the stage of the HIV epidemic and the sexual risk profile of the population. Despite its brief duration, AHI plays a disproportionate role in the sexual transmission of HIV infection. Detection of persons with AHI may provide an important opportunity for transmission prevention.