THE TRANSMISSION DYNAMICS OF HUMAN IMMUNODEFICIENCY VIRUS (HIV)
THE TRANSMISSION DYNAMICS OF HUMAN IMMUNODEFICIENCY VIRUS (HIV)
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DOI：
10.1098/rstb.1988.0108
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发表时间：
1988-10-31
影响因子：
6.3
通讯作者：
ANDERSON, RM
中科院分区：
文献类型：
--
作者：
MAY, RM;ANDERSON, RM
该论文首先回顾了发达国家和发展中国家的同性恋男性、异性恋者、静脉注射吸毒者以及受感染母亲所生儿童的艾滋病毒感染和艾滋病疾病数据。我们调查了目前可获得的信息，包括艾滋病毒感染和艾滋病出现之间的潜伏期分布、艾滋病毒感染者最终发展为艾滋病的比例、传染性的时间依赖性模式以及获得新性伴侣或共用针头伴侣的比率分布。有了这些信息，艾滋病毒传播动态的模型就被开发出来了，从故意过度简化的模型开始，并在由此获得的理解的基础上进展到更复杂的模型。在可能的情况下，模型参数的估计来自流行病学数据，并将预测与观察到的趋势进行比较。我们还将这些流行病学模型与人口因素结合起来，评估异性传播的艾滋病毒/艾滋病最终可能对非洲和其他国家的人口增长率、年龄特征以及相关经济和社会指标产生的影响。讨论了性或其他习惯必须改变到什么程度才能使艾滋病毒感染的“基本繁殖率”R0 低于统一值。最后，我们概述了模型的完善和开发以及流行病学数据的收集方面的一些研究需求。
The paper first reviews data on HIV infections and AIDS disease among homosexual men, heterosexuals, intravenous (IV) drug abusers and children born to infected mothers, in both developed and developing countries. We survey such information as is currently available about the distribution of incubation times that elapse between HIV infection and the appearance of AIDS, about the fraction of those infected with HIV who eventually go on to develop AIDS, about time-dependent patterns of infectiousness and about distributions of rates of acquiring new sexual or needle-sharing partners. With this information, models for the transmission of dynamics of HIV are developed, beginning with deliberately oversimplified models and progressing - on the basis of the understanding thus gained - to more complex ones. Where possible, estimates of the model''s parameters are derived from the epidemiological data, and predictions are compared with observed trends. We also combine these epidemiological models with demographic considerations to assess the effects that heterosexually-transmitted HIV/AIDS may eventually have on rates of population growth, on age profiles and on associated economic and social indicators, in African and other countries. The degree to which sexual or other habits must change to bring the ''basic reproductive rate'', R0, of HIV infections below unity is discussed. We conclude by outlining some research needs, both in the refinement and development of models and in the collection of epidemiological data.