Raggi R, Blanco G A
Cátedra de Patología II, Facultad de Ciencias Médicas, Universidad Nacional de La Plata, Argentina.
Medicina (B Aires). 1992;52(3):225-35.
The purpose of this paper was to evaluate the prevalence of HIV infection and AIDS in Argentina, to study the dynamics of the spread of HIV and to predict the future course by means of an epidemic model. The model was constructed using differential equations to describe the interactions between members of the various groups at risk. The functional form of the solutions was used in a back calculation procedure using data from cohort studies which were done in other countries (U.S.A. and France) together with data of AIDS cases reported to the National AIDS Program, to determine the time evolution of HIV-infection in each of the groups at risk defined. Results show that HIV was introduced in Argentina during the early 80's and affected persons of the homosexual/bisexual group in a first stage. In April 1990 it was estimated that there were a total of 34,131 HIV-infected persons. Intravenous drug users (IVDU) represented 39.5%, homosexual/bisexual men 47.6% and heterosexual adults 11%. It is estimated that in December 1992 there will be 107,946 HIV-infected persons where heterosexuals contribute with more than 20% of that value. AIDS cases predicted for the same period are 4130, with 1958 among homosexual/bisexual, 1483 among IVDU, 449 in heterosexual adults, 153 in children under 4 years old and 87 among hemophiliacs or patients with blood coagulation disorders. By the end of 1994 the model predicts more than 200,000 HIV infected persons with an important proportion of heterosexual adults and more than 12,000 AIDS cases. The values of this period must be considered as a future possible scenario if the present spread conditions are preserved. Infection among heterosexual adults is at the present time in a first and exponential phase of spread and dominated by transmission from IVDU group and bisexual men. It is concluded that the future course of AIDS epidemic in Argentina may be particularly influenced by changes in the heterosexual behavior particularly in those with a higher degree of exposure to HIV-infection.
本文旨在评估阿根廷艾滋病毒感染和艾滋病的流行情况,研究艾滋病毒的传播动态,并通过一个流行病模型预测未来的发展趋势。该模型利用微分方程构建,以描述不同风险群体成员之间的相互作用。利用来自其他国家(美国和法国)队列研究的数据以及向国家艾滋病项目报告的艾滋病病例数据,通过一个反推计算程序,采用解的函数形式,来确定所定义的每个风险群体中艾滋病毒感染的时间演变情况。结果表明,艾滋病毒于20世纪80年代初传入阿根廷,第一阶段影响的是同性恋/双性恋群体。1990年4月估计,共有34131名艾滋病毒感染者。静脉吸毒者占39.5%,同性恋/双性恋男性占47.6%,异性恋成年人占11%。据估计,到1992年12月将有107946名艾滋病毒感染者,其中异性恋者占该数字的20%以上。同期预测的艾滋病病例为4130例,其中同性恋/双性恋者中有1958例,静脉吸毒者中有1483例,异性恋成年人中有449例,4岁以下儿童中有153例,血友病患者或有凝血障碍的患者中有87例。到1994年底,该模型预测艾滋病毒感染者将超过20万,其中异性恋成年人占很大比例,艾滋病病例将超过12000例。如果保持目前的传播状况,这一时期的数值必须被视为未来可能出现的一种情况。目前,异性恋成年人中的感染处于传播的第一阶段且呈指数增长,主要由静脉吸毒者群体和双性恋男性传播所致。结论是,阿根廷艾滋病流行的未来发展趋势可能特别受异性恋行为变化的影响,尤其是那些接触艾滋病毒感染程度较高的人群。