Systematic review of orogenital HIV-1 transmission probabilities.
Systematic review of orogenital HIV-1 transmission probabilities.
复制标题
DOI：
10.1093/ije/dyn151
复制
发表时间：
2008-12
影响因子：
7.7
通讯作者：
Boily MC
中科院分区：
文献类型：
--
作者：
Baggaley RF;White RG;Boily MC
目的是评估艾滋病毒通过口生殖器性交（OI）传播的风险。方法按照MOOSE观察性研究综述指南对HIV-1通过OI传染性的文献进行系统综述。检索了PubMed数据库和相关文献的参考书目，截止日期为2007年7月。结果共检索了56214篇文献，从中确定了10篇潜在的研究;通过参考文献确定了另外两篇研究，通过与专家讨论确定了另一篇研究。纳入了10项研究，提供了每个伴侣（n = 5）的传播概率估计值、每个伴侣（n = 3）的发病率估计值、每个研究参与者（n = 3，在最初血清阴性的个体之后，其伴侣的血清状态未知）的估计值和每个行为（n = 3）的估计值。10项研究中只有4项报告了非零估计值：每个伴侣两项估计值（20%，95% CI：6-51，n = 10，基于模型的估计值为1%，范围为0.85-2.3%），每项研究参与者的估计值（0.37%，95% CI：0.10-1.34%）和一个按行为估计值（0.04%，95% CI：0.01-0.17%）。由于研究样本量较小，零估计值的95% CI上限往往相对较大：每个伴侣为9.0、12.1和2.8%;每个伴侣的发生率为4.7、9.6和1.8/100人-年;每个研究参与者为4.4%，每个行为为0.45和0.02%。鉴于研究数量较少，认为不适合进行荟萃分析。结论目前没有足够的数据来精确估计OI暴露的风险。已确定的研究表明传播风险较低，这意味着需要更多、更大规模的研究来提供足够的证据来得出更准确的估计。
Background The objective was to assess the risk of HIV transmission from orogenital intercourse (OI). Methods Systematic review of the literature on HIV-1 infectiousness through OI conducted according to MOOSE guidelines for reviews of observational studies. The PubMed database and bibliographies of relevant articles were searched to July 2007. Results Of the titles, 56 214 were searched from which 10 potentially appropriate studies were identified; two additional studies were identified through bibliographies and one through discussion with experts. There were 10 included studies, providing estimates of transmission probabilities per-partner (n = 5), incidence per-partner (n = 3), per-study participant (n = 3, following initially seronegative individuals whose partners are of unknown serostatus) and per-act (n = 3). Only four of 10 studies reported non-zero estimates: two per-partner estimates (20%, 95% CI: 6–51, n = 10 and a model-based estimate, 1%, range 0.85–2.3%), one per-study participant estimate (0.37%, 95% CI: 0.10–1.34%) and one per-act estimate (0.04%, 95% CI: 0.01–0.17%). Upper bounds for the 95% CI for zero estimates tended to be relatively large due to the small study sample sizes: 9.0, 12.1 and 2.8% for per-partner; 4.7, 9.6 and 1.8 per 100 person-years for incidence per-partner; 4.4% per-study participant and 0.45 and 0.02% for per-act. Given the small number of studies, a meta-analysis was not considered appropriate. Conclusions There are currently insufficient data to estimate precisely the risk from OI exposure. The low risk of transmission evident from identified studies means that more and larger studies would be required to provide sufficient evidence to derive more precise estimates.
登录
查看更多内容
影响因子：
3.8
作者：
Richters, J;Grulich, A;Kippax, S
通讯作者：
Kippax, S
影响因子：
120.7
作者：
WINKELSTEIN, W;LYMAN, DM;LEVY, JA
通讯作者：
LEVY, JA
影响因子：
3.8
作者：
Page-Shafer, K;Shiboski, CH;Greenspan, JS
通讯作者：
Greenspan, JS
影响因子：
158.5
作者：
DEVINCENZI, I
通讯作者：
DEVINCENZI, I
影响因子：
6.4
作者：
Celum, CL;Buchbinder, SP;Sheppard, HW
通讯作者：
Sheppard, HW