Nicolau J E, Benard G, Fonseca L A, Casseb J S, Sato M N, Cianga M, Tanji M M, Lorenzi T F, Duarte A J
Hemophilia Unit, Hospital Brigaderio, São Paulo State Health Department, Brazil.
Sao Paulo Med J. 1996 May-Jun;114(3):1186-9. doi: 10.1590/s1516-31801996000300008.
Nineteen Brazilian HIV-infected hemophiliacs and their stable heterosexual sexual partners were studied with the aim of assessing the rate of HIV transmission in this at risk group. The mean length of relationship between couples was 7.4 years. The hemophiliac men were Class II (n = 6), III (n = 11) and IVa (n = 2) of the CDC classification. They had decreased CD4+ and elevated CD8+ cell numbers; five had p24 antigenemia. We found 3 HIV-infected women (15.8 percent) by routine and confirmatory tests, a prevalence similar to that seen in other countries. They were asymptomatic and had no detectable p24 antigenemia. The 3 seropositive women's partners were Class II and III-CDC, and had normal CD4+ and CD8+ values and no p24 antigenemia. All seronegative women also had normal CD4+ and CD8+ numbers, except for elevated CD8+ cells in three of them, but immune abnormalities had already been seen in some seronegative partners at high risk for HIV infection. Our results reinforce previous suggestions that heterosexual transmission to stable female partners occurs preferentially early after initiation of sexual exposure, and possibly when the transmitter had high levels of viremia and regular sexual activity.
对19名巴西感染艾滋病毒的血友病患者及其稳定的异性性伴侣进行了研究，目的是评估这一高危人群中的艾滋病毒传播率。夫妻之间的平均关系持续时间为7.4年。血友病男性属于疾病控制与预防中心（CDC）分类中的II类（n = 6）、III类（n = 11）和IVa类（n = 2）。他们的CD4 +细胞数量减少，CD8 +细胞数量增加；5人出现p24抗原血症。通过常规和确诊检测，我们发现3名感染艾滋病毒的女性（15.8%），其患病率与其他国家所见相似。她们没有症状，也未检测到p24抗原血症。3名血清反应阳性女性的伴侣属于CDC的II类和III类，CD4 +和CD8 +值正常，且无p24抗原血症。所有血清反应阴性的女性CD4 +和CD8 +数量也均正常，不过其中3人的CD8 +细胞数量有所增加，但在一些有感染艾滋病毒高风险的血清反应阴性伴侣中已经观察到免疫异常。我们的结果强化了先前的推测，即艾滋病毒向稳定女性伴侣的异性传播优先发生在开始性接触后的早期，并且可能发生在传播者病毒血症水平较高且有规律性行为时。
