坦桑尼亚达累斯萨拉姆警察中艾滋病毒-1感染率和发病率下降——一个潜在的艾滋病毒疫苗试验队列

Declining HIV-1 prevalence and incidence among Police Officers - a potential cohort for HIV vaccine trials, in Dar es Salaam, Tanzania.

作者信息

Munseri Patricia J, Bakari Muhammad, Janabi Mohamed, Aris Eric, Aboud Said, Hejdeman Bo, Sandstrom Eric

机构信息

Department of Internal Medicine, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Box 65001, Tanzania.

出版信息

BMC Public Health. 2013 Aug 6;13:722. doi: 10.1186/1471-2458-13-722.

DOI:10.1186/1471-2458-13-722

PMID:23915014

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3750254/

Abstract

BACKGROUND

A safe effective and affordable HIV vaccine is the most cost effective way to prevent HIV infection worldwide. Current studies of HIV prevalence and incidence are needed to determine potentially suitable cohorts for vaccine studies. The prevalence and incidence of HIV-1 infection among the police in Dar es Salaam in 1996 were 13.8% and 19.6/1000 PYAR respectively. This study aimed at determining the current prevalence and incidence of HIV in a police cohort 10 years after a similar study was conducted.

METHODS

Police officers in Dar es Salaam, Tanzania were prospectively enrolled into the study from 2005 and followed-up in an incidence study three years later. HIV infection was determined by two sequential enzyme linked immunosorbent assays (ELISAs) in the prevalence study and discordant results between two ELISAs were resolved by a Western blot assay. Rapid HIV assays (SD Bioline and Determine) were used for the incidence study.

RESULTS

A total of 1,240 police participated in the HIV prevalence study from August 2005 to November 2008. Of these, 1101 joined the study from August 2005-September 2007 and an additional 139 were recruited between October 2007 to November 2008 while conducting the incidence study. A total of 726 (70%) out of the 1043 eligible police participated in the incidence study.The overall HIV-1 prevalence was 65/1240 (5.2%). Females had a non-statistically significant higher prevalence of HIV infection compared to males 19/253, (7.5%) vs. 46/987 (4.7%) respectively (p=0.07). The overall incidence of HIV-1 was 8.4 per 1000 PYAR (95% CI 4.68-14.03), and by gender was 8.8 and 6.9 per 1000 PYAR, among males and females respectively, (p=0.82).

CONCLUSIONS

The HIV prevalence and incidence among the studied police has declined over the past 10 years, and therefore this cohort is better suited for phase I/II HIV vaccine studies than for efficacy trials.

摘要

背景

一种安全、有效且可负担的HIV疫苗是全球预防HIV感染最具成本效益的方式。当前需要对HIV的流行率和发病率进行研究，以确定可能适合疫苗研究的队列。1996年，达累斯萨拉姆警察中HIV-1感染的流行率和发病率分别为13.8%和19.6/1000人年发病危险。本研究旨在确定在一项类似研究开展10年后，某警察队列中HIV的当前流行率和发病率。

方法

2005年起，对坦桑尼亚达累斯萨拉姆的警察进行前瞻性招募并纳入研究，3年后对其进行发病率研究随访。在流行率研究中，通过连续两次酶联免疫吸附测定（ELISA）确定HIV感染情况，两次ELISA结果不一致时，通过蛋白印迹法进行判定。发病率研究采用快速HIV检测法（SD Bioline和Determine）。

结果

2005年8月至2008年11月，共有1240名警察参与了HIV流行率研究。其中，1101人于2005年8月至2007年9月加入研究，另外139人在2007年10月至2008年11月开展发病率研究时被招募。1043名符合条件的警察中，共有726人（70%）参与了发病率研究。HIV-1总体流行率为65/1240（5.2%）。女性HIV感染流行率高于男性，但差异无统计学意义，分别为19/253（7.5%）和46/987（4.7%）（p=0.07）。HIV-1总体发病率为每1000人年发病危险8.4例（95%可信区间4.68 - 14.03），按性别划分，男性和女性分别为每1000人年发病危险8.8例和6.9例（p=0.82）。