Prevalence and incidence of HIV-1 and HIV-2 before, during and after a civil war in an occupational cohort in Guinea-Bissau, West Africa
Prevalence and incidence of HIV-1 and HIV-2 before, during and after a civil war in an occupational cohort in Guinea-Bissau, West Africa
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DOI：
10.1097/qad.0b013e32832cedfb
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发表时间：
2009-07-31
期刊：
影响因子：
3.8
通讯作者：
Norrgren, Hans
中科院分区：
文献类型：
--
作者：
Mansson, Fredrik;Biague, Antonio;Norrgren, Hans
目的：研究1990-2007年间HIV-1和HIV-2的流行和发病率，以及1998-1999年内战的影响。设计：对西非几内亚比绍4592名警察进行前瞻性队列研究。方法：将HIV-1和HIV-2的患病率和发病率分2-3年进行分析。结果：HIV-1感染率(包括HIV-1/HIV-2双反应性)从战前的0.6%逐渐上升到3.6%，战后第一次血清调查中为9.5%。在战争期间和战后不久，艾滋病毒-1发病率增加了一倍多，从每100人年0.50人增加到1.22人。在战后的随后时期，艾滋病毒-1的流行率和发病率都有所下降。在整个研究期间，艾滋病毒-2流行率从13.4%下降到6.2%，艾滋病毒-2发病率从每100人年1.38下降到0.18。根据纳入的混杂变量，HIV-2阳性者与HIV阴性者的HIV-1校正发病率比在1.02至1.18之间(不显著)。结论：HIV-1呈上升趋势，而HIV-2呈下降趋势，感染HIV-1的风险是HIV-2的4倍多。1998-1999年的内战似乎导致艾滋病毒-1传播暂时增加，但现在艾滋病毒-1的发病率和流行率似乎已经稳定下来。没有证据表明HIV-2对HIV-1感染有保护作用。(C)2009年Wolters Kluwer Health|Lippincott Williams&Wilkins
Objectives: To study prevalence and incidence of HIV-1 and HIV-2 between 1990 and 2007 and to examine impact of the civil war in 1998-1999. We also wanted to investigate possible interaction between HIV-1 and HIV-2.Design: Open prospective cohort study of 4592 police officers in Guinea-Bissau, West Africa.Methods: Analysis of HIV-1 and HIV-2 prevalence and incidence divided in 2-3 years time strata.Results: HIV-1 prevalence (including HIV-1/HIV-2 dual reactivity) increased gradually from 0.6 to 3.6% before the war and was 9.5% in the first serosurvey after the war. HIV-1 incidence more than doubled during and shortly after the war, from 0.50 to 1.22 per 100 person-years. Both prevalence and incidence of HIV-1 decreased in the following periods after the war. HIV-2 prevalence decreased from 13.4 to 6.2% during the entire study period and HIV-2 incidence decreased from 1.38 to 0.18 per 100 person-years. Adjusted incidence rate ratios of HIV-1 incidence in HIV-2-positive participants compared with HIV-negative participants ranged from 1.02 to 1.18 (not significant) depending on the confounding variables included.Conclusion: HIV-1 has increased, whereas HIV-2 has decreased and the risk of acquiring HIV-1 is now more than four times higher as compared with HIV-2. The civil war in 1998-1999 appears to have induced a temporary increase in HIV-1 transmission, but now a stabilization of HIV-1 incidence and prevalence seems to have taken place. There was no evidence of a protective effect of HIV-2 against HIV-1 infection. (C) 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins