Moss G B, Overbaugh J, Welch M, Reilly M, Bwayo J, Plummer F A, Ndinya-Achola J O, Malisa M A, Kreiss J K
Department of Medicine, University of Washington, Seattle, USA.
J Infect Dis. 1995 Dec;172(6):1469-74. doi: 10.1093/infdis/172.6.1469.
To evaluate the prevalence and correlates of human immunodeficiency virus (HIV)-infected cells in urethral secretions, samples were collected from 106 HIV-seropositive men with and without urethritis. HIV DNA was detected by polymerase chain reaction in 27% of 184 urethral specimens and was associated with CD4 cell depletion (P for trend, .03) and with urethritis (odds ratio [OR], 2.4; 95% confidence interval [CI], 1.2-4.6) or gonorrhea (OR, 2.9; 95% CI, 1.5-5.8). Two multivariate models were constructed that included age, CD4 cell count < 200/mm3, and either urethritis or gonococcal infection. Detection of HIV-infected cells in urethral secretions was independently associated with < 200 CD4 cells/mm3 (OR, 2.2; 95% CI, 0.9-5.2; P = .05) and urethritis (OR, 2.7; 95% CI, 1.3-5.3; P = .003) in the first model and with gonococcal infection (OR, 3.2; 95% CI, 1.6-6.4; P < .001) in the second model. Successful treatment of gonococcal urethritis was associated with a 2-fold reduction in urethral HIV DNA (44% vs. 21%; P = .02). Thus, treatment of gonococcal urethritis may be an effective strategy for reducing HIV transmission.
为评估尿道分泌物中人类免疫缺陷病毒（HIV）感染细胞的流行情况及其相关因素，我们收集了106名有或无尿道炎的HIV血清阳性男性的样本。通过聚合酶链反应在184份尿道标本中的27%检测到HIV DNA，其与CD4细胞耗竭相关（趋势P值，0.03），也与尿道炎（比值比[OR]，2.4；95%置信区间[CI]，1.2 - 4.6）或淋病（OR，2.9；95% CI，1.5 - 5.8）相关。构建了两个多变量模型，纳入了年龄、CD4细胞计数<200/mm³以及尿道炎或淋球菌感染。在第一个模型中，尿道分泌物中检测到HIV感染细胞与<200个CD4细胞/mm³（OR，2.2；95% CI，0.9 - 5.2；P = 0.05）和尿道炎（OR，2.7；95% CI，1.3 - 5.3；P = 0.003）独立相关；在第二个模型中，与淋球菌感染（OR，3.2；95% CI，1.6 - 6.4；P < 0.001）独立相关。淋菌性尿道炎的成功治疗与尿道HIV DNA减少两倍相关（44%对21%；P = 0.02）。因此，治疗淋菌性尿道炎可能是减少HIV传播的有效策略。
