McNeil J G, Brundage J F, Wann Z F, Burke D S, Miller R N
Division of Preventive Medicine, Walter Reed Army Institute of Research, Washington, D.C. 20307-5100.
N Engl J Med. 1989 Jun 15;320(24):1581-5. doi: 10.1056/NEJM198906153202403.
Direct measurement of the incidence of infection with the human immunodeficiency virus (HIV)--the rate of new HIV infection--is vital if we are to understand better the dynamics of the current epidemic of HIV infection. Because soldiers are periodically and routinely screened for antibody to HIV, it is possible to measure the incidence of HIV infection directly in this large, demographically well-characterized population of young adults. To determine the incidence of HIV infection in this population, we examined test results reported by the U.S. Army's routine antibody-screening programs. During the first two years of the screening programs, the observed incidence of HIV infection was approximately 0.77 per 1000 persons per year. This rate was higher than expected on the basis of previously published estimates of seroprevalence in the Army (approximately 1.50 per 1000). On the basis of this annual incidence, and assuming it to be stable, we estimate that approximately 600 soldiers will become infected with HIV each year. The observed rate in the Army may be lower than the incidence of HIV infection in the corresponding demographic groups within the general U.S. population.
如果我们想要更好地理解当前人类免疫缺陷病毒(HIV)感染流行的动态,直接测量HIV感染的发生率——即新的HIV感染率——至关重要。由于士兵会定期且常规地接受HIV抗体筛查,所以有可能在这个人口统计学特征明确的庞大年轻成年人群体中直接测量HIV感染的发生率。为了确定该人群中HIV感染的发生率,我们检查了美国陆军常规抗体筛查项目报告的检测结果。在筛查项目的头两年,观察到的HIV感染发生率约为每年每1000人中有0.77例。这个比率高于根据此前公布的陆军血清流行率估计值(约为每1000人中有1.50例)所预期的比率。基于这一年发病率,并假设其保持稳定,我们估计每年约有600名士兵会感染HIV。在陆军中观察到的比率可能低于美国普通人群中相应人口统计学群体的HIV感染发生率。