Recent HIV infection among pregnant women in the 2017 antenatal sentinel cross-sectional survey, South Africa: Assay-based incidence measurement.
Recent HIV infection among pregnant women in the 2017 antenatal sentinel cross-sectional survey, South Africa: Assay-based incidence measurement.
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DOI：
10.1371/journal.pone.0249953
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发表时间：
2021
期刊：
影响因子：
3.7
通讯作者：
Puren A
中科院分区：
文献类型：
--
作者：
Woldesenbet S;Kufa-Chakezha T;Lombard C;Manda S;Cheyip M;Ayalew K;Chirombo B;Barron P;Diallo K;Parekh B;Puren A
在南非，孕前和怀孕期间新感染艾滋病毒是母婴传播艾滋病毒的一个重要因素。这项研究估计了孕妇中艾滋病毒的发病率（定义为从调查之时起最近一年内的新感染，包括怀孕期间或怀孕前的新感染），并描述了全国最近感染艾滋病毒的孕妇的特征。在2017年10月1日至11月15日期间，我们对在1，595个公共设施接受产前护理的15-49岁孕妇进行了全国横断面调查。从孕妇身上采集血液样本，并在一个集中实验室进行艾滋病毒检测。对HIV阳性标本进一步进行血浆病毒载量和限制性抗原亲合力酶免疫吸附试验（LAg）检测，以区分近期和长期感染。近期感染的定义是在为调查收集血液样本之日起一年内发生的感染。通过访谈收集了年龄、伴侣年龄和婚姻状况等数据。其标本通过LAg检测被归类为近期感染且病毒载量> 1，000拷贝/mL的女性被视为近期感染。计算出的最近感染艾滋病毒的阳性妇女的比例进行了调整，以估计每年的发病率的检测特定的参数。调查多项逻辑回归被用来检查与最近感染的艾滋病毒阴性妇女作为参考组的因素。异性关系被定义为有一个比自己大5岁或更多的伴侣。在10，049名具有LAg和病毒载量数据的HIV阳性参与者中，1.4%（136）被确定为最近感染。艾滋病毒年发病率为1.5%（95%置信区间（CI）：1.2-1.7）。在多变量分析中，（调整的比值比，aOR：3.4，95% CI：1.8-6.2）或同居（aOR：3.8，95%CI：1.8-7.7），与已婚以及处于年龄差异关系的年轻女性相比，（aOR：3.1，95%CI：2.0-4.7;参考组：年轻女性（15- 24岁），其伴侣年龄不超过5岁）与近期感染的几率较高相关。与以前在孕妇中进行的研究相比，本研究估计的发病率显著降低。然而，艾滋病规划署到2020年将发病率降低75%（相当于将发病率降低到<1%）的目标尚未实现。应加强艾滋病毒预防和治疗干预措施的执行工作，以处于不同年龄段关系中的年轻妇女和未婚妇女为目标，以加快实现艾滋病规划署目标的进展。
New HIV infection during pre-conception and pregnancy is a significant contributor of mother–to–child transmission of HIV in South Africa. This study estimated HIV incidence (defined as new infection within the last one year from the time of the survey which included both new infections occurred during pregnancy or just before pregnancy) among pregnant women and described the characteristics of recently infected pregnant women at national level. Between 1 October and 15 November 2017, we conducted a national cross–sectional survey among pregnant women aged 15–49 years old attending antenatal care at 1,595 public facilities. Blood specimens were collected from pregnant women and tested for HIV in a centralised laboratory. Plasma viral load and Limiting Antigen Avidity Enzyme Immunosorbent Assay (LAg) tests were further performed on HIV positive specimens to differentiate between recent and long–term infections. Recent infection was defined as infection that occurred within one year from the date of collection of blood specimen for the survey. Data on age, age of partner, and marital status were collected through interviews. Women whose specimens were classified as recent by LAg assay and with viral loads >1,000 copies/mL were considered as recently infected. The calculated proportion of HIV positive women with recent infection was adjusted for assay–specific parameters to estimate annual incidence. Survey multinomial logistic regression was used to examine factors associated with being recently infected using HIV negative women as a reference group. Age–disparate relationship was defined as having a partner 5 or more years older. Of 10,049 HIV positive participants with LAg and viral load data, 1.4% (136) were identified as recently infected. The annual HIV incidence was 1.5% (95% confidence interval (CI): 1.2–1.7). In multivariable analyses, being single (adjusted odds ratio, aOR: 3.4, 95% CI: 1.8–6.2) or cohabiting (aOR: 3.8, 95% CI: 1.8–7.7), compared to being married as well as being in an age–disparate relationship among young women (aOR: 3.1, 95% CI: 2.0–4.7; reference group: young women (15–24years) whose partners were not 5 years or more older) were associated with higher odds of recent infection. Compared to previous studies among pregnant women, the incidence estimated in this study was substantially lower. However, the UNAIDS target to reduce incidence by 75% by 2020 (which is equivalent to reducing incidence to <1%) has not been met. The implementation of HIV prevention and treatment interventions should be intensified, targeting young women engaged in age–disparate relationship and unmarried women to fast track progress towards the UNAIDS target.
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影响因子：
3.7
作者：
Kim AA;Parekh BS;Umuro M;Galgalo T;Bunnell R;Makokha E;Dobbs T;Murithi P;Muraguri N;De Cock KM;Mermin J;2007 KAIS study group
通讯作者：
2007 KAIS study group
影响因子：
8.4
作者：
Ejigu, Yohannes;Magnus, Jeanette H.;Magnus, Maria
通讯作者：
Magnus, Maria
DOI：
10.1097/qad.0000000000001553
发表时间：
2017-07-31
期刊：
AIDS (London, England)
影响因子：
--
作者：
Akullian A;Bershteyn A;Klein D;Vandormael A;Bärnighausen T;Tanser F
通讯作者：
Tanser F
影响因子：
3.1
作者：
Chetty, Terusha;Vandormael, Alain;Coutsoudis, Anna
通讯作者：
Coutsoudis, Anna
影响因子：
4.5
作者：
Larsson, Elin C.;Thorson, Anna;Ekstrom, Anna Mia
通讯作者：
Ekstrom, Anna Mia