Gram Emma Grundtvig, Biering Ida Ege, Olsen Ole, Gram Gregers Jacob
Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Public Health. 2025 Feb;239:149-155. doi: 10.1016/j.puhe.2024.12.008. Epub 2025 Jan 19.
This systematic review aimed to assess the evidence on sexual transmission of HIV in high-income settings between serodiscordant couples where the index partner infected with HIV is on antiretroviral therapy.
Systematic review and meta-analyses.
We performed a systematic search in four databases: Embase, MEDLINE, The Cochrane Library, and Web of Science on September 24, 2022. We assessed the risk of bias with ROBINS-I and pooled estimates in meta-analyses using a Poisson regression model with a random effect of the study and population size. The study protocol was pre-registered at PROSPERO. The study involved high-income countries.
The search identified 6886 studies, of which six were included for review. Altogether, studies reported zero linked transmissions among 2383 couples, more than 160,000 acts of intercourse, and 3578 couple years. The risk estimate from overall meta-analyses was 0.000 95%CI (0.000-0.103) per 100 couple-years.
This systematic review and meta-analyses provide epidemiological evidence for a low risk of HIV transmission under antiretroviral therapy in high-income countries and thus cannot reject the theoretical "treatment as prevention" paradigm.
本系统评价旨在评估在高收入环境中，索引伴侣感染艾滋病毒且正在接受抗逆转录病毒治疗的血清学不一致夫妇之间艾滋病毒性传播的证据。
系统评价和荟萃分析。
2022年9月24日，我们在四个数据库中进行了系统检索：Embase、MEDLINE、Cochrane图书馆和Web of Science。我们使用具有研究和人群规模随机效应的泊松回归模型，通过ROBINS-I评估偏倚风险并在荟萃分析中汇总估计值。该研究方案已在PROSPERO预先注册。该研究涉及高收入国家。
检索到6886项研究，其中6项纳入综述。总体而言，研究报告在2383对夫妇、超过160000次性交行为和3578夫妇年中无关联传播。总体荟萃分析的风险估计为每100夫妇年0.000 95%CI（0.000 - 0.103）。
本系统评价和荟萃分析为高收入国家抗逆转录病毒治疗下艾滋病毒传播风险低提供了流行病学证据，因此不能拒绝理论上的“治疗即预防”范式。
