Rates of HIV-1 transmission per coital act, by stage of HIV-1 infection, in Rakai, Uganda
Rates of HIV-1 transmission per coital act, by stage of HIV-1 infection, in Rakai, Uganda
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DOI：
10.1086/429411
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发表时间：
2005-05-01
影响因子：
6.4
通讯作者：
Quinn, TC
中科院分区：
文献类型：
--
作者：
Wawer, MJ;Gray, RH;Quinn, TC
背景我们估计艾滋病病毒不一致的夫妇中，通过指数伴侣的感染阶段，每次性交的人类免疫缺陷病毒（HIV）-1传播率。我们回顾性地确定了235一夫一妻制，艾滋病毒不和谐的夫妇在乌干达人口为基础的队列。通过序列分析证实了艾滋病毒在配对中的传播。每次性交行为的传播率通过指数伴侣的感染阶段（近期血清转换或流行或晚期感染）进行估计。通过多变量Poisson回归估计经校正的每次性交传播率比。平均HIV传播率为0.0082/次（95%置信区间[CI]，0.0039-0.0150）在索引伴侣血清转换后2.5个月内相似;索引伴侣血清转换后6-15个月内0.0015/性交行为（95%CI，0.0002-0.0055）;在HIV流行的索引伴侣中，0.0007/性交行为（95%CI，0.0005-0.0010）;索引伴侣死亡前6-25个月，0.0028/性交行为（95%CI，0.0015-0.0041）。在调整后的模型中，早期和晚期感染、较高的HIV载量、生殖器溃疡疾病和指示性伴侣的年龄与较高的传播率显著相关。经性交传播的HIV感染率在感染早期最高。这对艾滋病毒预防和预测抗逆转录病毒治疗对艾滋病毒传播的影响具有影响。
Background. We estimated rates of human immunodeficiency virus (HIV)-1 transmission per coital act in HIV-discordant couples by stage of infection in the index partner.Methods. We retrospectively identified 235 monogamous, HIV-discordant couples in a Ugandan population-based cohort. HIV transmission within pairs was confirmed by sequence analysis. Rates of transmission per coital act were estimated by the index partner's stage of infection (recent seroconversion or prevalent or late-stage infection). The adjusted rate ratio of transmission per coital act was estimated by multivariate Poisson regression.Results. The average rate of HIV transmission was 0.0082/coital act (95% confidence interval [CI], 0.0039-0.0150) within similar to 2.5 months after seroconversion of the index partner; 0.0015/coital act within 6-15 months after seroconversion of the index partner (95% CI, 0.0002-0.0055); 0.0007/coital act (95% CI, 0.0005-0.0010) among HIV-prevalent index partners; and 0.0028/coital act (95% CI, 0.0015-0.0041) 6-25 months before the death of the index partner. In adjusted models, early- and late-stage infection, higher HIV load, genital ulcer disease, and younger age of the index partner were significantly associated with higher rates of transmission.Conclusions. The rate of HIV transmission per coital act was highest during early-stage infection. This has implications for HIV prevention and for projecting the effects of antiretroviral treatment on HIV transmission.