HIV-1 transmission, by stage of infection
HIV-1 transmission, by stage of infection
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DOI：
10.1086/590501
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发表时间：
2008-09-01
影响因子：
6.4
通讯作者：
Fraser, Christophe
中科院分区：
文献类型：
--
作者：
Hollingsworth, T. Deirdre;Anderson, Roy M.;Fraser, Christophe
背景。旨在减少早期或晚期感染期间 1 型人类免疫缺陷病毒 (HIV-1) 传播的公共卫生干预措施的流行病学影响取决于这些疾病阶段对特定流行病内传播的贡献。方法。通过使用稳健的概率框架，对乌干达拉凯的 HIV-1 血清不一致异性夫妇的传播风险和原发、无症状和晚期感染期间的高传染性持续时间进行了估计。结果。原发感染和晚期感染估计分别是无症状感染者的26倍和7倍，传染性比无症状感染者高。初次感染期间的高传染性估计会在血清转化后持续约 3 个月，而晚期感染期间的高传染性估计集中在死亡前 19 个月至 10 个月之间。结论。原发性和晚期 HIV-1 感染的传染性比之前估计的更强，但持续时间较短。在同质人群中，无症状感染阶段由于持续时间较长，通常对感染者一生中 HIV-1 的净传播贡献更大。讨论了感染阶段的相对贡献对性行为模式和流行病阶段的依赖性。
Background. The epidemiological impact of public health interventions targeted at reducing transmission of human immunodeficiency virus type 1 (HIV-1) during early or late-stage infection depends on the contribution of these disease stages to transmission within a particular epidemic.Methods. Transmission hazards and durations of periods of high infectivity during primary, asymptomatic, and late-stage infection were estimated for HIV-1-serodiscordant heterosexual couples in Rakai, Uganda, by use of a robust probabilistic framework.Results. Primary infection and late-stage infection were estimated to be 26 and 7 times, respectively, more infectious than asymptomatic infection. High infectiousness during primary infection was estimated to last for similar to 3 months after seroconversion, whereas high infectiousness during late-stage infection was estimated to be concentrated between 19 months and 10 months before death.Conclusions. Primary and late-stage HIV-1 infection are more infectious than previously estimated, but for shorter periods. In a homogeneous population, the asymptomatic stage of infection will typically contribute more to the net transmission of HIV-1 over the lifetime of an infected individual, because of its longer duration. The dependence of the relative contribution of infectious stages on patterns of sexual behavior and the phase of epidemics is discussed.