van de Water H P, Bijleveld C C, Berkane M, Wiggers C C
TNO Institute of Preventive Health Care, Leiden, The Netherlands.
Health Policy. 1992 Jul;21(3):211-21. doi: 10.1016/0168-8510(92)90019-8.
This article calculates back the HIV seroprevalence in the Netherlands from AIDS cases notified 1982-1990 and rates of progression from HIV to AIDS adopted from American studies. It discusses a number of problems, such as changing AIDS definitions and the possible impact of AZT treatment. We estimate that the Netherlands had approximately 6762 HIV seropositives by the end of 1988, which is considerably lower than earlier expectations. When a hypothetical decrease of 10% in the manifestation of AIDS cases due to AZT treatment was incorporated, the estimate for the end of 1988 becomes 7549. After deduction of the AIDS patients who had died by the beginning of 1989 from this estimate, the HIV seroprevalence by the end of 1988 is approximately 7000. The distribution of seroincidence over time suggests that the HIV epidemic in our country has passed its summit and that the HIV incidence is falling quickly. The question arises as to how far this fortunate development may be considered a success of the Dutch AIDS policy, a policy characterised by more openness than in many other countries. The material studied here, however, allows no definite answer to this intriguing question.
本文根据1982 - 1990年荷兰报告的艾滋病病例以及采用美国研究中的从感染艾滋病毒发展到患艾滋病的比率，倒推计算了荷兰的艾滋病毒血清阳性率。文中讨论了一些问题，比如艾滋病定义的变化以及齐多夫定治疗可能产生的影响。我们估计，到1988年底荷兰约有6762名艾滋病毒血清阳性者，这一数字远低于此前的预期。如果假设由于齐多夫定治疗使艾滋病病例表现减少10%，那么1988年底的估计数字变为7549。从这一估计数字中扣除到1989年初已死亡的艾滋病患者后，1988年底的艾滋病毒血清阳性率约为7000。血清感染率随时间的分布表明，我国的艾滋病毒疫情已过顶峰，艾滋病毒感染率正在迅速下降。问题是，这种幸运的发展在多大程度上可被视为荷兰艾滋病政策的成功，荷兰的艾滋病政策比许多其他国家的政策更具开放性。然而，这里所研究的材料无法对这个有趣的问题给出明确答案。
