Operskalski E A, Stram D O, Busch M P, Huang W, Harris M, Dietrich S L, Schiff E R, Donegan E, Mosley J W
Department of Medicine, University of Southern California, Los Angeles, USA.
Am J Epidemiol. 1997 Oct 15;146(8):655-61. doi: 10.1093/oxfordjournals.aje.a009331.
Eighteen transfusion recipients infected with human immunodeficiency virus type 1 (HIV-1) were followed prospectively with their 19 long-term sexual partners from 1986 to 1993 in California, Florida, and New York. Follow-up included clinical, behavioral, immunologic, serologic, and virologic evaluations. Two partners were already infected when seen 18 and 34 months after sexual contact began following the infectious transfusion. Four of 17 initially seronegative partners seroconverted during 23 person-years of observation. The recipient's clinical status, mononuclear cell subset variations, and time trend in CD4+ counts had no association with transmission. Individual plasma HIV-1 ribonucleic acid (RNA) loads were stable during observation, and sexual transmission was not attributable to an upward trend or transient burst in viremia. However, recipients who transmitted HIV-1 to their sexual partners had higher mean viral RNA levels than did nontransmitting recipients (4.3 vs. 3.6 log10 copies/ml; p = 0.05). Although this series was small, the prospective observations suggest that viral load was the only characteristic in the recipient that contributed to heterosexual infectiousness.
1986年至1993年期间，在加利福尼亚州、佛罗里达州和纽约州，对18名感染了1型人类免疫缺陷病毒（HIV-1）的输血接受者及其19名长期性伴侣进行了前瞻性随访。随访内容包括临床、行为、免疫、血清学和病毒学评估。在感染性输血后性接触开始18个月和34个月时，有两名伴侣已被感染。在23人年的观察期内，17名最初血清学阴性的伴侣中有4人发生了血清转化。接受者的临床状况、单核细胞亚群变化以及CD4+细胞计数的时间趋势与传播无关。在观察期间，个体血浆HIV-1核糖核酸（RNA）载量稳定，性传播并非归因于病毒血症的上升趋势或短暂爆发。然而，将HIV-1传播给其性伴侣的接受者的平均病毒RNA水平高于未传播者（4.3对3.6 log10拷贝/毫升；p = 0.05）。尽管该系列样本量较小，但前瞻性观察表明，病毒载量是接受者中导致异性传播感染的唯一特征。
