Carpenter C C, Mayer K H, Stein M D, Leibman B D, Fisher A, Fiore T C
Brown University AIDS Program, Providence, RI 02906.
Medicine (Baltimore). 1991 Sep;70(5):307-25. doi: 10.1097/00005792-199109000-00003.
This study was designed to define the epidemiology and natural history of human immunodeficiency virus (HIV) infection in women in Rhode Island. Two hundred women referred to Brown University physicians from 1986 through 1990 were evaluated at 3-to-6-month intervals for 12 to 60 months. All received antiretroviral therapy and prophylaxis against opportunistic infections when indicated on the basis of CD4 lymphocyte counts. Major findings included: 1) rapid shift of dominant mode of transmission from intravenous drug sharing to heterosexual route; 2) significant gender-specific differences in clinical presentation; 3) increased frequency of cervical dysplasia in women infected via intravenous needle sharing; 4) no definite gender-specific differences in progression of HIV infection; 5) enormous societal impact of HIV infection in women. Principal conclusions are: 1) rapid change to predominantly heterosexual HIV transmission can occur in North America, with serious societal impact; 2) gender-specific clinical features can lead to earlier diagnosis of HIV infection in women; 3) HIV infection in women does not pursue an inherently more rapid course than that observed in men.
本研究旨在明确罗德岛州女性人类免疫缺陷病毒（HIV）感染的流行病学特征及自然病程。1986年至1990年间转诊至布朗大学医生处的200名女性，每隔3至6个月接受评估，为期12至60个月。所有患者根据CD4淋巴细胞计数情况，在有指征时均接受抗逆转录病毒治疗及机会性感染预防。主要发现包括：1）主要传播方式从静脉注射毒品共用迅速转变为异性传播途径；2）临床表现存在显著的性别差异；3）通过静脉注射针头共用感染的女性宫颈发育异常频率增加；4）HIV感染进展方面无明确的性别差异；5）HIV感染对女性具有巨大的社会影响。主要结论为：1）在北美，HIV传播可迅速转变为以异性传播为主，具有严重的社会影响；2）特定性别的临床特征可使女性HIV感染得到更早诊断；3）女性HIV感染的病程本质上并不比男性更快。
