Estimating the impact of plasma HIV-1 RNA reductions on heterosexual HIV-1 transmission risk.
Estimating the impact of plasma HIV-1 RNA reductions on heterosexual HIV-1 transmission risk.
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DOI：
10.1371/journal.pone.0012598
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发表时间：
2010-09-13
期刊：
影响因子：
3.7
通讯作者：
Partners in Prevention HSV/HIV Transmission Study Team
中科院分区：
文献类型：
--
作者：
Lingappa JR;Hughes JP;Wang RS;Baeten JM;Celum C;Gray GE;Stevens WS;Donnell D;Campbell MS;Farquhar C;Essex M;Mullins JI;Coombs RW;Rees H;Corey L;Wald A;Partners in Prevention HSV/HIV Transmission Study Team
艾滋病毒-1经性传播的风险与血浆中艾滋病毒-1核糖核酸水平密切相关，这使得降低艾滋病毒-1血浆水平成为艾滋病毒-1预防干预措施的一个重要目标。定量了解血浆HIV-1RNA和HIV-1传播风险的关系有助于预测通过降低血浆HIV-1水平来实施的候选HIV-1预防干预措施的影响，例如抗逆转录病毒疗法(ART)、治疗性疫苗和其他非ART干预措施。我们使用2004年至2008年在东非和南部非洲HIV-1血清不一致夫妇中收集的前瞻性数据来模拟血浆HIV-1RNA水平和异性传播风险与通过HIV-1测序确认HIV-1传播事件的关系。该模型是基于对3381对HIV-1血清不一致夫妇5017人年的跟踪调查，包括108起与基因相关的HIV-1传播事件。HIV-1传播风险为2.27/100人年，与log10血浆HIV-1RNA呈对数线性关系。该模型预测，平均血浆HIV-1 RNA每毫升下降0.74log10拷贝/毫升(95%可信区间0.60至0.97)，可将异性传播风险降低50%，无论人群中的平均起始血浆HIV-1水平如何，也与其他与HIV-1相关的人群特征无关。在具有相似血浆艾滋病毒-1RNA分布的模拟人群中，该模型估计，通过血浆艾滋病毒-1RNA减少0.74拷贝/毫升而避免的总体艾滋病毒感染的90%可以通过将这一减少定向于血浆艾滋病毒-1水平≥为4log10拷贝/毫升的队列的58%来实现。这一血浆HIV-1水平和HIV-1性传播风险的对数线性模型可能有助于估计降低血浆HIV-1 RNA水平的候选干预措施对HIV-1传播和避免的感染的影响。
The risk of sexual transmission of HIV-1 is strongly associated with the level of HIV-1 RNA in plasma making reduction in HIV-1 plasma levels an important target for HIV-1 prevention interventions. A quantitative understanding of the relationship of plasma HIV-1 RNA and HIV-1 transmission risk could help predict the impact of candidate HIV-1 prevention interventions that operate by reducing plasma HIV-1 levels, such as antiretroviral therapy (ART), therapeutic vaccines, and other non-ART interventions. We use prospective data collected from 2004 to 2008 in East and Southern African HIV-1 serodiscordant couples to model the relationship of plasma HIV-1 RNA levels and heterosexual transmission risk with confirmation of HIV-1 transmission events by HIV-1 sequencing. The model is based on follow-up of 3381 HIV-1 serodiscordant couples over 5017 person-years encompassing 108 genetically-linked HIV-1 transmission events. HIV-1 transmission risk was 2.27 per 100 person-years with a log-linear relationship to log10 plasma HIV-1 RNA. The model predicts that a decrease in average plasma HIV-1 RNA of 0.74 log10 copies/mL (95% CI 0.60 to 0.97) reduces heterosexual transmission risk by 50%, regardless of the average starting plasma HIV-1 level in the population and independent of other HIV-1-related population characteristics. In a simulated population with a similar plasma HIV-1 RNA distribution the model estimates that 90% of overall HIV-1 infections averted by a 0.74 copies/mL reduction in plasma HIV-1 RNA could be achieved by targeting this reduction to the 58% of the cohort with plasma HIV-1 levels ≥4 log10 copies/mL. This log-linear model of plasma HIV-1 levels and risk of sexual HIV-1 transmission may help estimate the impact on HIV-1 transmission and infections averted from candidate interventions that reduce plasma HIV-1 RNA levels.
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DOI：
10.1097/qad.0b013e328312c756
发表时间：
2008-10-18
期刊：
AIDS (London, England)
影响因子：
--
作者：
Modjarrad K;Chamot E;Vermund SH
通讯作者：
Vermund SH
影响因子：
3.8
作者：
Walson, Judd L.;Otieno, Phelgona A.;Mbuchi, Margaret;Richardson, Barbra A.;Lohman-Payne, Barbara;Macharia, Steve Wanyee;Overbaugh, Julie;Berkley, James;Sanders, Eduard J.;Chung, Michael H.;John-Stewart, Grace C.
通讯作者：
John-Stewart, Grace C.
影响因子：
6.4
作者：
Zuckerman, Richard A.;Lucchetti, Aldo;Celum, Connie
通讯作者：
Celum, Connie
影响因子：
158.5
作者：
Collier, AC;Coombs, RW;Corey, L
通讯作者：
Corey, L
DOI：
10.1097/qai.0b013e3181831832
发表时间：
2008-09-01
影响因子：
3.6
作者：
Dunne, Eileen F.;Whitehead, Sara;Markowitz, Lauri
通讯作者：
Markowitz, Lauri