Genital HIV-1 RNA predicts risk of heterosexual HIV-1 transmission.
Genital HIV-1 RNA predicts risk of heterosexual HIV-1 transmission.
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DOI：
10.1126/scitranslmed.3001888
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发表时间：
2011-04-06
影响因子：
17.1
通讯作者：
Partners in Prevention HSV/HIV Transmission Study Team
中科院分区：
文献类型：
--
作者：
Baeten JM;Kahle E;Lingappa JR;Coombs RW;Delany-Moretlwe S;Nakku-Joloba E;Mugo NR;Wald A;Corey L;Donnell D;Campbell MS;Mullins JI;Celum C;Partners in Prevention HSV/HIV Transmission Study Team
高血浆HIV-1 RNA浓度与HIV-1传播风险增加相关。尽管血浆和生殖器HIV-1 RNA浓度相关，但没有研究评估生殖器HIV-1 RNA与异性传播HIV-1风险之间的关系。在一项对2521对非洲HIV-1血清不一致夫妇的前瞻性研究中，我们评估了生殖器HIV-1 RNA数量和HIV-1传播风险。通过病毒序列分析，在伙伴关系中建立了HIV-1传播联系。我们检测了1805名女性的宫颈内样本，其中46名将HIV-1传播给了其伴侣，以及716名男性的精液样本，其中32名将HIV-1传播给了其伴侣。生殖器和血浆HIV-1浓度相关：宫颈内膜拭子，Spearman等级相关系数rho为0.56 (p<0.001)，精液rho为0.55 （p<0.001）。生殖器HIV-1 RNA每增加1 log10， HIV-1传播风险增加2.20倍（宫颈内膜拭子，95%可信区间1.60-3.04,p<0.001）和1.79倍（精液，95%可信区间1.30-2.47,p<0.001）。在调整血浆HIV-1数量后，生殖器HIV-1 RNA独立预测HIV-1传播风险（宫颈内膜拭子的风险比为1.67，精液的风险比为1.68）。7例女性-男性和4例男性-女性HIV-1传播（每年发病率<1%）发生在生殖器HIV-1 RNA检测不到的人群中，但在所有11例血浆中均检测到HIV-1 RNA。因此，较高的生殖器HIV-1 RNA浓度与异性传播HIV-1的风险相关，且这种影响与血浆HIV-1浓度无关。这些数据表明生殖器分泌物中的HIV-1 RNA可以作为HIV-1性传播风险的标记物。
High plasma HIV-1 RNA concentrations are associated with an increased risk of HIV-1 transmission. Although plasma and genital HIV-1 RNA concentrations are correlated, no study has evaluated the relationship between genital HIV-1 RNA and the risk of heterosexual HIV-1 transmission. In a prospective study of 2521 African HIV-1 serodiscordant couples, we assessed genital HIV-1 RNA quantity and HIV-1 transmission risk. HIV-1 transmission linkage was established within the partnership by viral sequence analysis. We tested endocervical samples from 1805 women, including 46 who transmitted HIV-1 to their partner, and semen samples from 716 men, including 32 who transmitted HIV-1 to their partner. Genital and plasma HIV-1 concentrations were correlated: For endocervical swabs, Spearman’s rank correlation coefficient rho was 0.56 (p<0.001), and for semen rho was 0.55 (p<0.001). Each 1 log10 increase in genital HIV-1 RNA was associated with a 2.20-fold (for endocervical swabs, 95% confidence interval 1.60–3.04, p<0.001) and a 1.79-fold (for semen, 95% confidence interval 1.30–2.47, p<0.001) increased risk of HIV-1 transmission. Genital HIV-1 RNA independently predicted HIV-1 transmission risk after adjusting for plasma HIV-1 quantity (hazard ratio 1.67 for endocervical swabs and 1.68 for semen). Seven female-to-male and four male-to-female HIV-1 transmissions (incidence <1% per year) occurred from persons with undetectable genital HIV-1 RNA, but in all eleven plasma HIV-1 RNA was detected. Thus, higher genital HIV-1 RNA concentrations are associated with greater risk of heterosexual HIV-1 transmission, and this effect was independent of plasma HIV-1 concentrations. These data suggest that HIV-1 RNA in genital secretions could be used as a marker of HIV-1 sexual transmission risk.
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影响因子：
9.4
作者：
ASHLEY, RL;MILITONI, J;COREY, L
通讯作者：
COREY, L
影响因子：
3.4
作者：
Kaul, R.;Pettengell, C.;Rebbapragada, A.
通讯作者：
Rebbapragada, A.
影响因子：
3.7
作者：
Lingappa JR;Hughes JP;Wang RS;Baeten JM;Celum C;Gray GE;Stevens WS;Donnell D;Campbell MS;Farquhar C;Essex M;Mullins JI;Coombs RW;Rees H;Corey L;Wald A;Partners in Prevention HSV/HIV Transmission Study Team
通讯作者：
Partners in Prevention HSV/HIV Transmission Study Team
影响因子：
17.1
作者：
Butler DM;Delport W;Kosakovsky Pond SL;Lakdawala MK;Cheng PM;Little SJ;Richman DD;Smith DM
通讯作者：
Smith DM
影响因子：
3.7
作者：
Lingappa, Jairam R.;Kahle, Erin;Celum, Connie
通讯作者：
Celum, Connie