Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar; Population Health Research Institute, St George's, University of London, London, UK.
Infectious Disease Epidemiology Group, Weill Cornell Medicine-Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar.
Int J Infect Dis. 2018 Jan;66:131-134. doi: 10.1016/j.ijid.2017.10.022. Epub 2017 Nov 10.
To estimate the annual risk of HIV transmission (ϕ) within HIV sero-discordant couples in 23 countries in sub-Saharan Africa (SSA), by utilizing newly available national population-based data and accounting for factors known to potentially affect this estimation.
We used a recently developed pair-based mathematical model that accommodates for HIV-dynamics temporal variation, sexual risk-behavior heterogeneity, and antiretroviral therapy (ART) scale-up.
Estimated country-specific ϕ (in absence of ART) ranged between 4.2% (95% uncertainty interval (UI): 1.9%-6.3%) and 47.4% (95% UI: 37.2%-69.0%) per person-year (ppy), with a median of 12.4%. ϕ was strongly associated with HIV prevalence, with a Pearson correlation coefficient of 0.92, and was larger in high- versus low-HIV-prevalence countries. ϕ increased by 1.31% (95% confidence interval: 1.00%-1.55%) ppy for every 1% increase in HIV prevalence.
ϕ estimates were similar to earlier estimates, and suggested considerable heterogeneity in HIV infectiousness across SSA. This heterogeneity may explain, partly, the differences in epidemic scales.
利用新获得的基于人群的国家数据，并考虑到可能影响这一估计的因素，来估计撒哈拉以南非洲 23 个国家中 HIV 血清不一致夫妇中 HIV 传播的年风险（ϕ）。
我们使用了一种新开发的基于对的数学模型，该模型可以适应 HIV 动力学的时间变化、性行为风险行为的异质性和抗逆转录病毒疗法（ART）的扩展。
在没有 ART 的情况下，估计的特定国家的ϕ（每人均年）范围为 4.2%（95%不确定区间（UI）：1.9%-6.3%）至 47.4%（95% UI：37.2%-69.0%），中位数为 12.4%。ϕ与 HIV 流行率密切相关，Pearson 相关系数为 0.92，在高 HIV 流行率国家比低流行率国家更大。HIV 流行率每增加 1%，ϕ就会增加 1.31%（95%置信区间：1.00%-1.55%）。
ϕ的估计与早期的估计相似，并表明撒哈拉以南非洲的 HIV 传染性存在相当大的异质性。这种异质性可能部分解释了流行规模的差异。
