Segura Marcela, Bautista Christian T, Marone Ruben, Sosa Estani Sergio, Rey Jorge, Montano Silvia M, Griemberg Gloria, Weissenbacher Mercedes, Avila Maria M
Departamento de Microbiologia, Parasitologia e Inmunologia, Centro Nacional de Referencia para el SIDA, Universidad de Buenos Aires, Argentina.
AIDS Care. 2010 Dec;22(12):1459-65. doi: 10.1080/09540121003758556.
In a previous cohort study among 327 men who have sex with men (MSM) in Buenos Aires, an HIV incidence rate of 3.9 per 100 persons-year was reported. Using data from this study, we determined: (a) HIV/STI co-infections; (b) clinical manifestations of incident HIV infections; (c) syphilis incidence and its associated risk factors; and (d) adherence and immune response to hepatitis B virus (HBV) vaccine. During the cohort study, 12 incident HIV infections were found. Within this group, HIV infection alone was most frequent (42%), followed by co-infection of HIV/HBV (33%), and triple co-infection of HIV/HBV/syphilis (25%). The most frequent clinical manifestations among incident HIV cases were: pharyngitis, fever, lymphadenopathy, asthenia, and myalgia. Seven new syphilis infections were detected yielding an incidence rate of 2.4 (95% CI=1.07 - 4.73) per 100 persons-year. Sex work was the only significant risk factor associated with syphilis seroconversion (hazard rate=10.93, p-value=0.033). Only 7% of cohort participants reported having received HBV vaccine. Ninety-percent of the 204 cohort members who agreed to be vaccinated completed the HBV vaccination schedule with an immune response rate of 85%. Our findings suggest the need to increase the access to serologic testing for STI and HBV immunization, as well as the developing of effective HIV/STI behavioral and educational prevention programs among MSM in Buenos Aires.
在之前一项针对布宜诺斯艾利斯327名男男性行为者（MSM）的队列研究中，报告的艾滋病毒发病率为每100人年3.9例。利用该研究的数据，我们确定了：（a）艾滋病毒/性传播感染合并感染情况；（b）新发艾滋病毒感染的临床表现；（c）梅毒发病率及其相关危险因素；以及（d）对乙型肝炎病毒（HBV）疫苗的依从性和免疫反应。在队列研究期间，发现了12例新发艾滋病毒感染病例。在这组病例中，单纯艾滋病毒感染最为常见（42%），其次是艾滋病毒/乙肝病毒合并感染（33%），以及艾滋病毒/乙肝病毒/梅毒三重合并感染（25%）。新发艾滋病毒病例中最常见的临床表现为：咽炎、发热、淋巴结病、乏力和肌痛。检测到7例新梅毒感染病例，发病率为每100人年2.4例（95%CI = 1.07 - 4.73）。性工作是与梅毒血清转化相关的唯一显著危险因素（风险率 = 10.93，p值 = 0.033）。只有7%的队列参与者报告接种过乙肝疫苗。在同意接种疫苗的204名队列成员中，90%完成了乙肝疫苗接种程序，免疫反应率为85%。我们的研究结果表明，有必要增加性传播感染血清学检测和乙肝免疫接种的可及性，以及在布宜诺斯艾利斯的男男性行为者中制定有效的艾滋病毒/性传播感染行为和教育预防方案。
