HIV-1 INCIDENCE AND HIV-1-ASSOCIATED MORTALITY IN A RURAL UGANDAN POPULATION COHORT
HIV-1 INCIDENCE AND HIV-1-ASSOCIATED MORTALITY IN A RURAL UGANDAN POPULATION COHORT
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DOI：
10.1097/00002030-199401000-00013
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发表时间：
1994-01-01
期刊：
影响因子：
3.8
通讯作者：
KENGEYAKAYONDO, JF
中科院分区：
文献类型：
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作者：
MULDER, DW;NUNN, AJ;KENGEYAKAYONDO, JF
目的：确定乌干达农村人群中HIV-1感染和HIV-1相关死亡率的发生率。设计：前瞻性队列研究。方法：1989年至1990年期间，通过人口和医学调查，对乌干达西南部马萨卡县15个村庄的人口（法律人口普查9820）进行队列研究。所有年龄段的HIV-1血清患病率为4.8%，13岁及以上的人群为8.2%。1年后再次进行调查。结果：成人1年HIV-1发病率为1%[9.2 / 1000人-年观察；95%置信区间（CI）， 5.5-12.9)。共观察到84例死亡。在成人中，半数死亡（60人中有31人）是hiv -1血清阳性个体。艾滋病毒阳性成人与艾滋病毒阴性成人的年龄校正总死亡率比为20.8 （95% CI, 12.0-35.7）。在13-44岁年龄组中，男性、女性和男女的相应比率分别为16.3、108.9和58.7。在成年男性、成年女性和25-34岁的成年人（男女加起来）中，可归因于艾滋病毒的死亡率比例，即在没有艾滋病毒的情况下可以避免的死亡比例，分别为44%、50%和89%。hiv -1血清阳性成人1年死亡进展率为10.3%。结论：这些结果表明艾滋病毒-1流行病对乌干达农村地区成人死亡率的深远影响，该地区成人艾滋病毒-1患病率和发病率分别为8%和1%。
Objective: To determine the incidence of HIV-1 infection and HIV-1-associated mortality in a rural Ugandan population.Design: A prospective cohort study.Methods: A cohort consisting of the population (de jure census 9820) of a cluster of 15 villages in Masaka District, south-west Uganda was enrolled between 1989 and 1990 through a demographic and medical survey. The HIV-1 seroprevalence rate was 4.8% for all ages combined and 8.2% for those aged 13 years or more. The survey was repeated after 1 year.Results: The 1-year HIV-1 incidence rate among adults was 1% [9.2 per 1000 person-years of observation; 95% confidence interval (CI), 5.5-12.9). A total of 84 deaths were observed. In adults, half of all deaths (31 out of 60) were in HIV-1-seropositive individuals. The age-adjusted overall mortality rate ratio for HIV-positive adults compared with HIV-negatives was 20.8 (95% CI, 12.0-35.7). In the 13-44 age group the corresponding rate ratios for men, women and both sexes combined were 16.3, 108.9 and 58.7, respectively. The HIV-attributable mortality fractions, i.e., the proportion of deaths that would have been avoided in the absence of HIV, were 44, 50 and 89% for adult men, adult women and adults aged 25-34 years (both sexes combined), respectively. The 1-year progression to death among HIV-1-seropositive adults was 10.3%.Conclusion: These results demonstrate the profound impact that the HIV-1 epidemic has on adult mortality in a rural area of Uganda where the HIV-1 prevalence and incidence rates in adults are 8 and 1%, respectively.