Prevalence and risk factors of cervicovaginal HIV shedding among HIV-1 and HIV-2 infected women in Dakar, Senegal
Prevalence and risk factors of cervicovaginal HIV shedding among HIV-1 and HIV-2 infected women in Dakar, Senegal
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塞内加尔达喀尔 HIV-1 和 HIV-2 感染妇女宫颈阴道 HIV 传播的患病率和危险因素
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发表时间：
2001
影响因子：
3.6
通讯作者：
E. Delaporte
中科院分区：
文献类型：
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作者：
K. Seck;N. Samb;S. Tempesta;C. Mulanga;D. Henzel;P. Sow;A. Coll;S. Mboup;I. Ndoye;E. Delaporte
目的：评估塞内加尔达喀尔妇女宫颈阴道脱落HIV-1和HIV-2的风险决定因素和流行率。方法：我们进行了一项横断面研究的153艾滋病毒血清阳性女性性工作者（FSW）和另外142艾滋病毒血清阳性妇女参加传染病单位，基于访谈，体检，和实验室筛查主要性传播感染（STI）。采用巢式PCR检测宫颈阴道灌洗液中的HIV-RNA。通过使用比值比和95%置信区间确定宫颈阴道HIV-1和HIV-2脱落与社会人口统计学、临床和实验室变量之间的联系。Logistic回归分析用于确定与HIV脱落的独立联系。结果如下：FSW宫颈阴道灌洗液中HIV-RNA的检出率较低，HIV-1（7/90：8%）和HIV-2（3/48：6%）的检出率无显著性差异。其他妇女的感染率要高得多（艾滋病毒1型和2型感染率分别为41%，48/117; 33%，7/21）。在多变量分析中，高血浆病毒载量（> 40 000拷贝/ml）（AOR = 2.4（1.0 - 5.6）p = 0.04）和基础阴道pH值（AOR = 2.2（1.3 - 3.7）p = 0.002）与HIV-1脱落独立相关。对于HIV-2，CD4计数<200个细胞× 106/l是与HIV-2脱落相关的唯一因素（AOR = 9.0（0.9 - 93））。HIV-1的生殖器脱落率高于HIV-2（OR = 2.1（0.9 - 4.8）），但调整CD4+细胞计数后，这种差异消失（AOR = 1.2（0.5 - 2.9））。结论：晚期疾病和免疫抑制是HIV-1和HIV-2脱落的主要危险因素。阴道基本pH值也是HIV-1脱落的风险决定因素。
Objectives: To assess the risk determinants and prevalence of cervicovaginal shedding of HIV-1 and HIV-2 among women in Dakar, Senegal. Methods: We conducted a cross sectional study of 153 HIV seropositive female sex workers (FSW) and another 142 HIV seropositive women attending an infectious diseases unit, based on an interview, physical examination, and laboratory screening for major sexually transmitted infections (STI). Cervicovaginal lavage fluid was tested for HIV-RNA by means of nested PCR. Links between cervicovaginal shedding of HIV-1 and HIV-2 and sociodemographic, clinical, and laboratory variables were identified by using odd ratios and 95% confidence intervals. Logistic regression analysis was used to identify independent links with HIV shedding. Results: The detection rate of HIV-RNA in cervicovaginal lavage fluid was low among FSW, with no difference between HIV-1 (7/90: 8%) and HIV-2 (3/48: 6%). The rate was far higher among the other women (41%, 48/117; 33%, 7/21 for HIV-1 and HIV-2, respectively). In multivariate analysis, high plasma viral load (>40 000 copies/ml) (AOR = 2.4 (1.0–5.6) p = 0.04) and basic vaginal pH (AOR = 2.2 (1.3–3.7) p = 0.002) were independently associated with HIV-1 shedding. For HIV-2 a CD4 count < 200 cells × 106/l was the only factor associated with the shedding of HIV-2 (AOR = 9.0 (0.9–93)). The genital shedding rate was higher with HIV-1 than with HIV-2 (OR = 2.1 (0.9–4.8), but this difference disappeared after adjustment for the CD4+ cell count (AOR = 1.2 (0.5–2.9)). Conclusion: Advanced disease stage and immunosuppression are the major risk determinants for shedding of both HIV-1 and HIV-2. Basic vaginal pH is also a risk determinant for HIV-1 shedding.
影响因子：
6.4
作者：
Martin, HL;Richardson, BA;Kreiss, J
通讯作者：
Kreiss, J
影响因子：
158.5
作者：
Quinn, TC;Wawer, MJ;Gray, RH
通讯作者：
Gray, RH