Thorsteinsson Kristina, Ladelund Steen, Jensen-Fangel Søren, Larsen Mette Vang, Johansen Isik Somuncu, Katzenstein Terese L, Pedersen Gitte, Storgaard Merete, Obel Niels, Lebech Anne-Mette
Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark.
Scand J Infect Dis. 2012 Oct;44(10):766-75. doi: 10.3109/00365548.2012.684220. Epub 2012 Jul 17.
Gender differences in the risk of AIDS-defining illness (ADI) and mortality have been reported in the HIV-1-infected (HIV-positive) population, with conflicting findings. We aimed to assess the impact of gender on the risk of ADI and death in HIV-positive patients infected sexually.
This was a population-based, nationwide cohort study of incident Danish HIV-positive individuals infected by sexual contact. Outcomes were progression to AIDS and death. We used Cox proportional hazards models and Poisson regression analyses to calculate the risk of progression to AIDS and mortality rate ratios (MRR) between risk groups and compared these with the general Danish population.
We identified 587 heterosexually infected women, 583 men who have sex with women (MSW), and 1089 men who have sex with men (MSM). The total follow-up time was 13,708 person-y. At the time of HIV diagnosis MSM had a lower prevalence of AIDS compared to MSW. Women and MSW presented more often with tuberculosis and less often with AIDS-defining cancers compared to MSM. In the adjusted analyses we observed no differences in progression to AIDS. In the adjusted analyses of risk of death, there were no differences between the 3 risk groups, although we saw a trend towards a higher risk of death in older MSW. MSM had a lower risk of death compared to the background population than women and MSW.
In the Danish HIV population, gender has no major impact on progression to AIDS or mortality. Differences in these factors between women, MSW, and MSM are mainly due to confounding from race and CD4 + cell count at diagnosis.
在人类免疫缺陷病毒1型（HIV-1）感染（HIV阳性）人群中，已报告了艾滋病定义疾病（ADI）风险和死亡率方面的性别差异，但结果相互矛盾。我们旨在评估性别对性传播感染HIV阳性患者发生ADI和死亡风险的影响。
这是一项基于人群的全国性队列研究，研究对象为丹麦通过性接触感染HIV的新发患者。结局指标为进展至艾滋病和死亡。我们使用Cox比例风险模型和泊松回归分析来计算风险组之间进展至艾滋病的风险和死亡率比（MRR），并将这些结果与丹麦普通人群进行比较。
我们确定了587名异性感染女性、583名与女性发生性行为的男性（MSW）和1089名与男性发生性行为的男性（MSM）。总随访时间为13708人年。在HIV诊断时，与MSW相比，MSM的艾滋病患病率较低。与MSM相比，女性和MSW患结核病的情况更常见，而患艾滋病定义癌症的情况则较少见。在调整分析中，我们未观察到进展至艾滋病方面的差异。在死亡风险的调整分析中，三个风险组之间没有差异，尽管我们发现年龄较大的MSW有死亡风险较高的趋势。与背景人群相比，MSM的死亡风险低于女性和MSW。
在丹麦HIV人群中，性别对进展至艾滋病或死亡率没有重大影响。女性、MSW和MSM在这些因素上的差异主要是由于诊断时种族和CD4 +细胞计数的混杂因素所致。
