Gürtler Lutz G, Eberle Josef
Max von Pettenkofer Institute, National Reference Centre for Retroviruses, Ludwig-Maximilians-University of München, Pettenkofer Str 9A, 80336, Munich, Germany.
Med Microbiol Immunol. 2017 Aug;206(4):287-293. doi: 10.1007/s00430-017-0505-2. Epub 2017 Apr 22.
Transmission of infectious agents might be associated with iatrogenic actions of charitable help in health care. An example is the vaccination against yellow fever in USA that transmitted hepatitis B virus. Another example is injections of praziquantel for treatment and cure of schistosomiasis in Central and Northern Africa, with a focus in Egypt that has spread hepatitis C virus. There is no indication that human T-lymphotropic virus type 1 was spread by injection treatment for African trypanosomiasis, syphilis and treponematosis, but these treatments might have contributed to the early spread of human immunodeficiency virus type 1 (HIV-1) in Central Africa. Slave trade contributed as well to the spread of viruses from Africa to the Americas; it was stopped in 1850. Until that date HIV-1 was not transported to the Americas. By analysis of nucleic acid sequence data it can be concluded that the continental spread of HCV and HIV-1 might have started around 1920 with an exponential phase from 1940 to 1970. Further iatrogenic actions that promoted the spread of HCV and HIV-1 might be vaccinations to prevent deadly diseases. The successful vaccination was followed by diminution of the infectious agent in the population such as small pox, yellow fever and measles. Measurements to reduce the spread of plague and cholera were further benefits increasing survival of diseased subjects in a population. Thus, the reduction of exposure to deadly infectious agents might have given a chance to HIV-1 infected subjects to survive and for HIV-1 to be distributed around the world starting from Central Africa in the 1950s.
传染源的传播可能与医疗保健中慈善救助的医源性行为有关。一个例子是美国的黄热病疫苗接种传播了乙型肝炎病毒。另一个例子是在中非和北非注射吡喹酮治疗血吸虫病,重点是在埃及,这传播了丙型肝炎病毒。没有迹象表明1型人类嗜T淋巴细胞病毒是通过注射治疗非洲锥虫病、梅毒和密螺旋体病传播的,但这些治疗可能促成了1型人类免疫缺陷病毒(HIV-1)在中非的早期传播。奴隶贸易也促成了病毒从非洲传播到美洲;它于1850年被禁止。在此之前,HIV-1没有被传播到美洲。通过对核酸序列数据的分析可以得出结论,丙型肝炎病毒和HIV-1的洲际传播可能始于1920年左右,在1940年至1970年进入指数期。促进丙型肝炎病毒和HIV-1传播的其他医源性行为可能是预防致命疾病的疫苗接种。成功接种疫苗后,人群中的传染源如天花、黄热病和麻疹减少。减少鼠疫和霍乱传播的措施还有进一步的好处,即提高了人群中患病者的生存率。因此,减少接触致命传染源可能使感染HIV-1的个体有机会存活下来,并使HIV-1从20世纪50年代开始从非洲中部传播到世界各地。