Kreiss J K, Koech D, Plummer F A, Holmes K K, Lightfoote M, Piot P, Ronald A R, Ndinya-Achola J O, D'Costa L J, Roberts P
N Engl J Med. 1986 Feb 13;314(7):414-8. doi: 10.1056/NEJM198602133140704.
The acquired immunodeficiency syndrome (AIDS) is epidemic in Central Africa. To determine the prevalence of AIDS virus infection in East Africa, we studied 90 female prostitutes, 40 men treated at a clinic for sexually transmitted diseases, and 42 medical personnel in Nairobi, Kenya. Antibody to human T-cell lymphotropic virus Type III (HTLV-III) was detected in the serum of 66 percent of prostitutes of low socioeconomic status, 31 percent of prostitutes of higher socioeconomic status, 8 percent of the clinic patients, and 2 percent of the medical personnel. The presence of the antibody was associated with both immunologic and clinical abnormalities. The mean T-cell helper/suppressor ratio was 0.92 in seropositive prostitutes and 1.82 in seronegative prostitutes (P less than 0.0001). Generalized lymphadenopathy was present in 54 percent of seropositive prostitutes and 10 percent of seronegative prostitutes (P less than 0.0001). No constitutional symptoms, opportunistic infections, or cases of Kaposi's sarcoma were present. Our results indicate that the epidemic of AIDS virus infection has, unfortunately, spread extensively among urban prostitutes in Nairobi, Kenya. Sexual exposure to men from Central Africa was significantly associated with HTLV-III antibody among prostitutes, suggesting transcontinental spread of the epidemic.
获得性免疫缺陷综合征（艾滋病）在中非地区流行。为确定东非地区艾滋病病毒感染的流行情况，我们对肯尼亚内罗毕的90名女性妓女、40名在性病诊所接受治疗的男性以及42名医务人员进行了研究。在社会经济地位较低的妓女中，66%的人血清中检测到了人类T细胞嗜淋巴细胞病毒III型（HTLV-III）抗体；社会经济地位较高的妓女中，这一比例为31%；诊所患者中为8%；医务人员中为2%。抗体的存在与免疫和临床异常情况均有关联。血清阳性妓女的T细胞辅助/抑制细胞比值平均为0.92，血清阴性妓女为1.82（P<0.0001）。54%的血清阳性妓女有全身性淋巴结肿大，血清阴性妓女中这一比例为10%（P<0.0001）。未出现全身症状、机会性感染或卡波西肉瘤病例。我们的研究结果表明，不幸的是，艾滋病病毒感染在肯尼亚内罗毕的城市妓女中已广泛传播。妓女中与来自中非的男性有性接触与HTLV-III抗体显著相关，提示该流行病已跨洲传播。
