Reduced fertility among HIV-infected women associated with viral load in Rakai district, Uganda
Reduced fertility among HIV-infected women associated with viral load in Rakai district, Uganda
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DOI：
10.1258/095646206779307586
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发表时间：
2006-12-01
影响因子：
1.4
通讯作者：
Gray, Ronald H.
中科院分区：
文献类型：
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作者：
Nguyen, Ruby H. N.;Gange, Stephen J.;Gray, Ronald H.
我们在一项针对乌干达拉凯区社区队列的 HIV 阳性女性的巢式病例对照研究中，评估了 HIV-1 病毒载量是否影响 HIV 阳性女性活产的可能性。病例为活产妇女 (n = 270)，对照为性活跃、未采取避孕措施且在随访期间未怀孕的妇女 (n = 263)。在活产妇女和非妊娠对照妇女中，HIV 病毒载量中位数分别为 4.12 logl(10) 拷贝/mL 和 4.41 log(10) 拷贝/mL（P = 0.001）。观察到非线性关联，并拟合了 4.5 log(10) 拷贝/mL 样条结的分段线性回归。我们观察到，在 3.0 和 4.49 log(10) 病毒载量之间，log（调整后优势比 [adj. OR]）= -0.08（95% 置信区间 [CI]：-0.36, 0.20）下降，在 4.5 和 6.5 log(10) 病毒载量之间，log（调整后优势比 [adj. OR]）= -0.92（95% CI：-1.21，-0.63）下降。两次减少量之间存在显着差异 (P < 0.001)。 4.5 log(10) 后 log(10) 病毒载量的每次增加都会导致调整。活产 OR 为之前病毒载量类别的 12%。我们的数据表明，病毒载量较高的艾滋病毒阳性女性的活产能力可能存在相当大的差异。
We assessed whether HIV-1 viral load affects the likelihood of live birth among HIV-positive women in a nested case-control study of HIV-positive women from a community cohort in Rakai District, Uganda. Cases were women who had a live birth (n = 270), and controls were sexually active women who did not use contraception and did not become pregnant during follow-up (n = 263). In women with a live birth and non-pregnant controls, median HIV viral loads were 4.12 logl(10) copies/mL and 4.41 log(10) copies/mL, respectively (P = 0.001). A non-linear association was observed, and a segmented linear regression with spline knot at 4.5 log(10) copies/mL was fit. We observed a decline in the log (adjusted odds ratio [adj. OR]) = -0.08 (95% confidence interval [CI]: -0.36, 0.20) between 3.0 and 4.49 log(10) viral load and -0.92 (95% CI: -1.21, -0.63) between 4.5 and 6.5 log(10) viral load. The two reductions differed significantly from one another (P < 0.001). Each increase in log(10) viral load after 4.5 log(10) resulted in an adj. OR of live birth which was 12% of the previous viral load category. Our data suggest that there may be considerable differences in the ability to produce a live birth among HIV-positive women with high viral loads.