建立模型以模拟接受抗逆转录病毒疗法的性活跃嗜酒男性向血清阴性妻子传播艾滋病毒的情况。
Modeling HIV Transmission from Sexually Active Alcohol-Consuming Men in ART Programs to Seronegative Wives.
机构信息
University of Connecticut Division of Infectious Diseases, Farmington, CT, USA.
University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.
出版信息
J Int Assoc Provid AIDS Care. 2020 Jan-Dec;19:2325958220952287. doi: 10.1177/2325958220952287.
BACKGROUND
The rollout of antiviral therapy in Low and Middle Income Countries (LMICs) has reduced HIV transmission rates at the potential risk of resistant HIV transmission. We sought to predict the risk of wild type and antiviral resistance transmissions in these settings.
METHODS
A predictive model utilizing viral load, ART adherence, genital ulcer disease, condom use, and sexual event histories was developed to predict risks of HIV transmission to wives of 233 HIV+ men in 4 antiretroviral treatment centers in Maharashtra, India.
RESULTS
ARV Therapy predicted a 5.71-fold reduction in transmissions compared to a model of using condoms alone, with 79.9%, of remaining transmissions resulting in primary ART-resistance.
CONCLUSIONS
ART programs reduce transmission of HIV to susceptible partners at a substantial increased risk for transmission of resistant virus. Enhanced vigilance in monitoring adherence, use of barrier protections, and viral load may reduce risks of resistant HIV transmissions in LMIC settings.
背景
在中低收入国家（LMICs）推出抗病毒疗法，降低了艾滋病毒传播率，但也有可能导致抗药性艾滋病毒的传播。我们试图预测这些环境中野生型和抗病毒耐药性传播的风险。
方法
利用病毒载量、ART 依从性、生殖器溃疡病、避孕套使用和性事件史，为印度马哈拉施特拉邦的 4 个抗逆转录病毒治疗中心的 233 名 HIV+男性的妻子们开发了一个预测 HIV 传播风险的预测模型。
结果
与单独使用避孕套的模型相比，ARV 治疗预测传播风险降低了 5.71 倍，剩余传播中有 79.9%导致原发性 ART 耐药性。
结论
ART 项目降低了 HIV 向易感伴侣的传播风险，但传播耐药病毒的风险显著增加。在 LMIC 环境中，加强对依从性、使用屏障保护和病毒载量的监测，可以降低耐药性 HIV 传播的风险。
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