External infections contribute minimally to HIV incidence among HIV sero-discordant couples in sub-Saharan Africa.
External infections contribute minimally to HIV incidence among HIV sero-discordant couples in sub-Saharan Africa.
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DOI：
10.1136/sextrans-2012-050651
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发表时间：
2013-03
影响因子：
3.6
通讯作者：
Abu-Raddad LJ
中科院分区：
文献类型：
--
作者：
Chemaitelly H;Abu-Raddad LJ
最近在撒哈拉以南非洲 (SSA) 稳定的 HIV 血清不一致夫妇 (SDC) 中进行的随机临床试验报告称，约 20-30% 的新 HIV 感染是从外部性伴侣获得的，而不是从感染者传播给夫妇内未感染的伴侣。本研究的目的是检验这些发现是否以及在多大程度上适用于 SSA 更广泛人群中的 SDC。构建了一个数学模型来计算 SDC 中因夫妇外部来源导致的新 HIV-1 感染比例。该模型使用 SSA 20 个国家的经验数据和基于人口的数据进行参数化。还进行了不确定性和敏感性分析。外部感染在 SDC 中的贡献通常不大，但在 SSA 中差异很大。在艾滋病毒感染率低的国家（≤3.0%），这一比例在 0.6-2.9% 之间。在中等流行率国家（3.0-18.0%），这一比例为 4.9-11.7%。斯威士兰和莱索托是世界上疫情最严重的国家，感染率分别高达 27.9% 和 27.3%。在 SSA 的大多数国家，SDC 中未感染艾滋病毒的伴侣几乎所有感染艾滋病毒的情况似乎都是由 SDC 中感染 HIV 的伴侣传播的。外部获得性感染的贡献因艾滋病毒人口患病率而异，但在大多数国家很少超过 10%。只有在高流行性 HIV 流行中，外部感染的贡献才相当大，并且可能达到最近涉及 SDC 的随机临床试验中报告的水平。
Recent randomised clinical trials among stable HIV sero-discordant couples (SDCs) in sub-Saharan Africa (SSA) have reported that about 20–30% of new HIV infections are acquired from external sexual partners, rather than transmitted from the infected to the uninfected partner within the couple. The aim of this study is to examine whether, and to what extent, these findings are generalisable to SDCs in the wider population in SSA. A mathematical model was constructed to calculate the fraction of new HIV-1 infections among SDCs that are due to sources external to the couple. The model was parameterised using empirical and population-based data for 20 countries in SSA. Uncertainty and sensitivity analyses were also conducted. The contribution of external infections among SDCs was generally modest, but it varied widely across SSA. In low HIV prevalence countries (≤3.0%), it ranged from 0.6–2.9%. In intermediate prevalence countries (3.0–18.0%), it ranged from 4.9–11.7%. In Swaziland and Lesotho, the world's most-intense epidemics, sizable levels of 27.9% and 27.3% were found, respectively. In most countries in SSA, nearly all HIV acquisitions by the uninfected partners in SDCs appear to be due to transmissions from the HIV infected partners in the SDCs. The contribution of externally acquired infections varies with HIV population prevalence, but rarely exceeds 10% in the majority of countries. Only in hyperendemic HIV epidemics the contribution of external infections is substantial and may reach the levels reported in recent randomised clinical trials involving SDCs.
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影响因子：
6.4
作者：
Hughes, James P.;Baeten, Jared M.;Celum, Connie
通讯作者：
Celum, Connie
DOI：
10.1097/qai.0b013e318237b864
发表时间：
2012-01-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
--
作者：
Ndase P;Celum C;Thomas K;Donnell D;Fife KH;Bukusi E;Delany-Moretlwe S;Baeten JM;Partners in Prevention HSVHIV Transmission Study Team
通讯作者：
Partners in Prevention HSVHIV Transmission Study Team
影响因子：
3.8
作者：
Reynolds, Steven J.;Makumbi, Frederick;Serwadda, David
通讯作者：
Serwadda, David
影响因子：
6.7
作者：
Hollingsworth TD;Laeyendecker O;Shirreff G;Donnelly CA;Serwadda D;Wawer MJ;Kiwanuka N;Nalugoda F;Collinson-Streng A;Ssempijja V;Hanage WP;Quinn TC;Gray RH;Fraser C
通讯作者：
Fraser C
影响因子：
6.4
作者：
Wawer, MJ;Gray, RH;Quinn, TC
通讯作者：
Quinn, TC