HIV-1 infection incidence among persons with hemophilia in the United States and western Europe, 1978-1990. Multicenter Hemophilia Cohort Study.
HIV-1 infection incidence among persons with hemophilia in the United States and western Europe, 1978-1990. Multicenter Hemophilia Cohort Study.
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发表时间：
1994-02
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通讯作者：
B. Kroner;P. Rosenberg;L. Aledort;W. Alvord;J. Goedert
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作者：
B. Kroner;P. Rosenberg;L. Aledort;W. Alvord;J. Goedert
我们研究了美国和欧洲16个中心血友病患者队列中人类免疫缺陷病毒1型（HIV-1）感染率随时间的变化，并估计了所有血清阳性受试者最可能的血清转换日期。5家美国研究中心招募了与HIV-1状态无关的受试者，而11家研究中心优先纳入血清阳性受试者。我们从五个中心获得了无偏的HIV-1感染发病率估计值，并从所有中心的血清阳性分布中获得了血清转换的估计日期。在五中心队列中，感染发生率开始于1978年，在1982年10月达到高峰，每100人年有22例感染风险，到1984年7月下降到每100人年4例。1987年以后很少发生感染，到那时，50%的队列已经感染。所有血清阳性亚组的中位血清转换日期范围为1980年7月至1983年12月，取决于浓缩因子的剂量和类型。欧洲的中位日期范围为1981年9月至1983年3月，反映了使用美国血浆生产的产品。感染发生率显然在采取公共卫生干预措施以减少传播的同时达到高峰。这些干预措施，包括对因子浓缩物进行热处理和推迟高危献血者，防止了HIV-1感染在血友病患者的年轻出生队列中流行。
We studied human immunodeficiency virus type 1 (HIV-1) infection incidence over time in a 16-center cohort of hemophiliacs in the United States and Europe and estimated the most likely date of seroconversion for all seropositive subjects. Five U.S. centers enrolled subjects independent of HIV-1 status, whereas 11 centers preferentially included seropositive subjects. We obtained unbiased estimates of HIV-1 infection incidence rates from the five centers and estimated dates of seroconversion from the distribution seen among seropositives from all centers. In the five-center cohort, infection incidence began in 1978, peaked in October 1982 at 22 infections per 100 person-years at risk, and declined to 4 per 100 person-years by July 1984. Few infections occurred after 1987, and by that time, 50% of the cohort had become infected. Median seroconversion dates for subgroups of all seropositives ranged from July 1980 to December 1983, depending on the dose and type of factor concentrate. Median dates in Europe ranged from September 1981 to March 1983 and reflected the use of products manufactured from American plasma. Infection incidence apparently peaked about the same time that public health interventions were introduced to reduce transmission. These interventions, including heat treatment of factor concentrates and deferral of high-risk donors, have prevented HIV-1 infection from becoming endemic among younger birth cohorts of persons with hemophilia.