Human Immunodeficiency Virus Infection in North American Women: Experience with 200 Cases and a Review of the Literature
Human Immunodeficiency Virus Infection in North American Women: Experience with 200 Cases and a Review of the Literature
复制标题
北美女性人类免疫缺陷病毒感染：200例经验及文献复习
作者：
C. Carpenter;K. Mayer;M. Stein;Bryan D. Leibman;A. Fisher;T. Fiore
这项研究旨在确定罗德岛州妇女感染人类免疫缺陷病毒(HIV)的流行病学和自然病史。从1986年到1990年，200名被推荐到布朗大学内科医生的女性接受了为期12到60个月的评估，每隔3到6个月进行一次。所有人都接受了抗逆转录病毒治疗和预防机会性感染，这是根据CD4淋巴细胞计数显示的。主要发现包括：1)主要传播方式从静脉注射毒品迅速转变为异性传播途径；2)临床表现存在显著的性别差异；3)通过静脉注射针头感染的妇女宫颈发育不良的发生率增加；4)艾滋病毒感染的进展没有明确的性别差异；5)艾滋病毒感染对妇女的巨大社会影响。主要结论是：1)北美可能发生以异性为主的艾滋病毒传播的快速变化，具有严重的社会影响；2)特定性别的临床特征可导致妇女更早诊断出艾滋病毒感染；3)妇女感染艾滋病毒的过程并不比观察到的男子更快。
This study was designed to define the epidemiology and natural history of human immunodeficiency virus (HIV) infection in women in Rhode Island. Two hundred women referred to Brown University physicians from 1986 through 1990 were evaluated at 3-to-6-month intervals for 12 to 60 months. All received antiretroviral therapy and prophylaxis against opportunistic infections when indicated on the basis of CD4 lymphocyte counts. Major findings included: 1) rapid shift of dominant mode of transmission from intravenous drug sharing to heterosexual route; 2) significant gender-specific differences in clinical presentation; 3) increased frequency of cervical dysplasia in women infected via intravenous needle sharing; 4) no definite gender-specific differences in progression of HIV infection; 5) enormous societal impact of HIV infection in women. Principal conclusions are: 1) rapid change to predominantly heterosexual HIV transmission can occur in North America, with serious societal impact; 2) gender-specific clinical features can lead to earlier diagnosis of HIV infection in women; 3) HIV infection in women does not pursue an inherently more rapid course than that observed in men.