Lavreys Ludo, Baeten Jared M, Kreiss Joan K, Richardson Barbra A, Chohan Bhavna H, Hassan Wisal, Panteleeff Dana D, Mandaliya Kishorchandra, Ndinya-Achola Jeckoniah O, Overbaugh Julie
Department of Epidemiology, Medicine, and Biostatistics, University of Washington, Seattle, Washington 98104-2499, USA.
J Infect Dis. 2004 Jan 15;189(2):303-11. doi: 10.1086/380974. Epub 2004 Jan 9.
We examined the association between host factors present near the time of human immunodeficiency virus type 1 (HIV-1) acquisition and subsequent virus loads, in a prospective cohort study of women in Mombasa, Kenya. Women were prospectively followed monthly before HIV-1 infection. One hundred sixty-one commercial sex workers who became infected with HIV-1 were followed for a median of 34 months, and 991 plasma samples collected > or =4 months after infection were tested for HIV-1 RNA. The median virus set point at 4 months after infection was 4.46 log10 copies/mL, and the average virus load increase during subsequent follow-up was 0.0094 log10 copies/mL/month. In a multivariate analysis that controlled for sexual behavior, the use of the injectable contraceptive depot medroxyprogesterone acetate (DMPA) at the time of HIV-1 infection was associated with a higher virus set point, and the presence of genital ulcer disease (GUD) during the early phase of HIV-1 infection was associated with greater change in virus load during follow-up. These findings suggest that, in women, the use of DMPA and the presence of GUD during the early phase of HIV-1 infection may influence the natural course of infection.
在肯尼亚蒙巴萨对女性进行的一项前瞻性队列研究中，我们调查了在感染1型人类免疫缺陷病毒（HIV-1）前后出现的宿主因素与后续病毒载量之间的关联。在HIV-1感染前，对女性进行每月一次的前瞻性随访。对161名感染HIV-1的商业性工作者进行了为期34个月的中位数随访，并对感染后≥4个月采集的991份血浆样本进行了HIV-1 RNA检测。感染后4个月的病毒载量中位数为4.46 log10拷贝/毫升，在后续随访期间病毒载量的平均增加量为0.0094 log10拷贝/毫升/月。在一项控制了性行为的多变量分析中，HIV-1感染时使用注射用避孕针剂醋酸甲羟孕酮（DMPA）与更高的病毒载量设定点相关，而在HIV-1感染早期出现生殖器溃疡疾病（GUD）与随访期间病毒载量的更大变化相关。这些发现表明，在女性中，HIV-1感染早期使用DMPA和出现GUD可能会影响感染的自然病程。
