Pinkerton Steven D
Center for AIDS Intervention Research, Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 2071 North Summit Avenue, Milwaukee, WI 53202, USA.
AIDS Behav. 2008 Sep;12(5):677-84. doi: 10.1007/s10461-007-9329-1. Epub 2007 Dec 7.
Accurate estimates of the probability of HIV transmission during various stages of infection are needed to inform epidemiological models. Very limited information is available about the probability of transmission during acute HIV infection. We conducted a secondary analysis of published data from the Rakai, Uganda seroconversion study. Mathematical and computer-based models were used to quantify the per-act and per-partnership transmission probabilities during acute and chronic HIV infection, and to estimate how many of the transmission events reported in the Rakai study were due to acute-phase HIV transmission. The average per-act transmission probability during acute infection equaled 0.03604 vs. 0.00084 for chronic HIV infection. Overall, HIV was transmitted during acute infection in 46.5% of 23 "incident index partner couples." Acute-phase transmission accounted for 89.1% of all transmission events in the first 20 months of follow-up. These results highlight the substantial risk of transmission during acute HIV infection.
为完善流行病学模型，需要准确估计不同感染阶段的HIV传播概率。目前关于急性HIV感染期间传播概率的信息非常有限。我们对乌干达拉凯血清转化研究的已发表数据进行了二次分析。使用数学和计算机模型来量化急性和慢性HIV感染期间每次行为及每个性伴关系的传播概率，并估计拉凯研究中报告的传播事件中有多少是由急性期HIV传播所致。急性感染期间平均每次行为的传播概率为0.03604，而慢性HIV感染为0.00084。总体而言，在23对“新发索引性伴夫妇”中，有46.5%在急性感染期发生了HIV传播。在随访的前20个月中，急性期传播占所有传播事件的89.1%。这些结果凸显了急性HIV感染期间的巨大传播风险。
