Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco.
Decreases in community viral load are accompanied by reductions in new HIV infections in San Francisco.
复制标题
DOI：
10.1371/journal.pone.0011068
复制
发表时间：
2010-06-10
期刊：
影响因子：
3.7
通讯作者：
Colfax GN
中科院分区：
文献类型：
--
作者：
Das M;Chu PL;Santos GM;Scheer S;Vittinghoff E;McFarland W;Colfax GN
在个人层面上，较高的HIV病毒载量预示着性传播的风险。我们评估了旧金山的社区病毒载量（CVL）作为HIV传播风险的人群水平标记。我们假设，2004-2008年旧金山CVL的下降，与HIV检测率、抗逆转录病毒治疗（ART）覆盖率和有效性的增加以及人群水平的病毒学抑制相对应，将与新发HIV感染的减少有关。我们使用旧金山的艾滋病毒/艾滋病监测系统来检查CVL的趋势。平均CVL计算为一个特定社区中所有报告的hiv阳性个体最近病毒载量的平均值。总CVL被定义为特定社区中所有hiv阳性个体最近病毒载量的总和。我们使用具有稳健标准误差的泊松模型来评估平均和总CVL与主要结局（每年新诊断的HIV病例数）之间的关系。从2004年到2008年，平均和总CVL都有所下降，同时新诊断的艾滋病毒从798例（2004年）下降到434例（2008年）。平均CVL （p = 0.003）和总CVL （p = 0.002）与2004-2008年新发HIV病例显著相关。CVL的减少与HIV感染的减少有关。结果表明，大规模抗逆转录病毒治疗可以减少人群水平上的艾滋病毒传播。由于CVL暂时处于新发艾滋病毒感染的上游，各司法管辖区应考虑将CVL纳入常规艾滋病毒监测，以跟踪疫情、分配资源并评估艾滋病毒预防和治疗工作的有效性。
At the individual level, higher HIV viral load predicts sexual transmission risk. We evaluated San Francisco's community viral load (CVL) as a population level marker of HIV transmission risk. We hypothesized that the decrease in CVL in San Francisco from 2004–2008, corresponding with increased rates of HIV testing, antiretroviral therapy (ART) coverage and effectiveness, and population-level virologic suppression, would be associated with a reduction in new HIV infections. We used San Francisco's HIV/AIDS surveillance system to examine the trends in CVL. Mean CVL was calculated as the mean of the most recent viral load of all reported HIV-positive individuals in a particular community. Total CVL was defined as the sum of the most recent viral loads of all HIV-positive individuals in a particular community. We used Poisson models with robust standard errors to assess the relationships between the mean and total CVL and the primary outcome: annual numbers of newly diagnosed HIV cases. Both mean and total CVL decreased from 2004–2008 and were accompanied by decreases in new HIV diagnoses from 798 (2004) to 434 (2008). The mean (p = 0.003) and total CVL (p = 0.002) were significantly associated with new HIV cases from 2004–2008. Reductions in CVL are associated with decreased HIV infections. Results suggest that wide-scale ART could reduce HIV transmission at the population level. Because CVL is temporally upstream of new HIV infections, jurisdictions should consider adding CVL to routine HIV surveillance to track the epidemic, allocate resources, and to evaluate the effectiveness of HIV prevention and treatment efforts.
登录
查看更多内容
DOI：
10.1097/qai.0b013e3181bbc99e
发表时间：
2009-11-01
影响因子：
3.6
作者：
Harries, Anthony D.;Zachariah, Rony;Kamoto, Kelita
通讯作者：
Kamoto, Kelita
影响因子：
3.8
作者：
Koenig, SP;Léandre, F;Farmer, PE
通讯作者：
Farmer, PE
影响因子：
6.4
作者：
Fang, CT;Hsu, HM;Chuang, CY
通讯作者：
Chuang, CY
DOI：
10.1097/00126334-200112010-00012
发表时间：
2001-12-01
期刊：
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
影响因子：
--
作者：
Kellogg, TA;Clements-Nolle, K;McFarland, W
通讯作者：
McFarland, W
DOI：
10.1097/00126334-200204150-00009
发表时间：
2002-04-15
期刊：
JOURNAL OF ACQUIRED IMMUNE DEFICIENCY SYNDROMES
影响因子：
--
作者：
Cooper, ER;Charurat, M;Blattner, W
通讯作者：
Blattner, W