Xia Qiang, Sun Xuming, Wiewel Ellen W, Torian Lucia V
New York City Department of Health and Mental Hygiene, Bureau of HIV Prevention and Control, HIV Epidemiology and Field Services Program, New York, NY.
J Acquir Immune Defic Syndr. 2017 Jun 1;75(2):143-147. doi: 10.1097/QAI.0000000000001311.
The widespread use of antiretroviral treatment made HIV prevalence no longer a good measure of population-level transmission risk. The objective of this analysis was to use the prevalence of unsuppressed HIV to describe population-level HIV transmission risk.
Using New York City (NYC) HIV surveillance data, we reported HIV prevalence and the prevalence of unsuppressed HIV, defined as the number of persons living with HIV with an unsuppressed viral load divided by population size.
The estimated number of persons living with HIV in NYC increased from 79,100 [95% confidence interval (CI): 78,200 to 80,000] in 2010 to 81,700 (95% CI: 80,500 to 82,900) in 2014. HIV prevalence (≥18 years old) remained unchanged at 1.22% (95% CI: 1.21% to 1.24%) in 2010 and 1.22% (95% CI: 1.20% to 1.24%) in 2014. The prevalence of unsuppressed HIV (≥18 years old) steadily decreased from 0.49% (95% CI: 0.48% to 0.51%) in 2010 to 0.34% (95% CI: 0.32% to 0.36%) in 2014. Men had both higher HIV prevalence (1.86% vs. 0.65% in 2014) and higher prevalence of unsuppressed HIV (0.51% vs. 0.18% in 2014) than women. In 2014, the black-white ratio of prevalence of unsuppressed HIV was 5.8 among men and 26.3 among women, and the Hispanic-white ratio was 2.7 among men and 10.0 among women.
The prevalence of unsuppressed HIV has been steadily decreasing in NYC. As antiretroviral treatment continues to expand, programs should consider using the prevalence of unsuppressed HIV to measure population-level transmission risk.
抗逆转录病毒治疗的广泛应用使得艾滋病病毒流行率不再是衡量人群层面传播风险的良好指标。本分析的目的是利用未得到病毒抑制的艾滋病病毒流行率来描述人群层面的艾滋病病毒传播风险。
利用纽约市艾滋病病毒监测数据，我们报告了艾滋病病毒流行率以及未得到病毒抑制的艾滋病病毒流行率，后者定义为病毒载量未得到抑制的艾滋病病毒感染者人数除以人口规模。
纽约市艾滋病病毒感染者估计人数从2010年的79100人[95%置信区间（CI）：78200至80000]增至2014年的81700人（95%CI：80500至82900）。2010年艾滋病病毒流行率（≥18岁）保持在1.22%（95%CI：1.21%至1.24%），2014年为1.22%（95%CI：1.20%至1.24%）。未得到病毒抑制的艾滋病病毒流行率（≥18岁）从2010年的0.49%（95%CI：0.48%至0.51%）稳步降至2014年的0.34%（95%CI：0.32%至0.36%）。男性的艾滋病病毒流行率（2014年为1.86%对0.65%）和未得到病毒抑制的艾滋病病毒流行率（2014年为0.51%对0.18%）均高于女性。2014年，男性中未得到病毒抑制的艾滋病病毒流行率的黑白比为5.8，女性为26.3；西班牙裔与白人的流行率之比在男性中为2.7，在女性中为10.0。
纽约市未得到病毒抑制的艾滋病病毒流行率一直在稳步下降。随着抗逆转录病毒治疗的持续推广，相关项目应考虑使用未得到病毒抑制的艾滋病病毒流行率来衡量人群层面的传播风险。
