Kiviat N B, Critchlow C W, Hawes S E, Kuypers J, Surawicz C, Goldbaum G, van Burik J A, Lampinen T, Holmes K K
Department of Pathology, School of Medicine, University of Washington, and Seattle-King County Department of Public Health 98109, USA.
J Infect Dis. 1998 Mar;177(3):571-8. doi: 10.1086/514239.
To define the determinants of anal-rectal shedding of human immunodeficiency virus (HIV) DNA and RNA, 374 HIV-seropositive homosexual men were tested. Factors independently associated with detection of anal-rectal HIV DNA included anal-rectal inflammation and detection of anal human papillomavirus DNA; predictors of HIV RNA included detection of anal-rectal HIV DNA, anal-rectal inflammation, and high plasma HIV RNA levels. The latter (>10,000 copies/mL) was the main determinant of anal-rectal HIV RNA shedding when HIV DNA (e.g., HIV-infected cells) was not detected in the anal-rectal sample. The local presence of HIV-infected cells and local inflammation were the principal determinants of HIV RNA among those with low (<10,000 copies/mL) plasma HIV RNA load. Among those with anal-rectal HIV DNA present, increased HIV RNA plasma load did not increase the risk of shedding of HIV RNA into the anal-rectal canal.
为确定人类免疫缺陷病毒（HIV）DNA和RNA在肛门直肠部位脱落的决定因素，对374名HIV血清阳性的同性恋男性进行了检测。与检测到肛门直肠HIV DNA独立相关的因素包括肛门直肠炎症和肛门人乳头瘤病毒DNA的检测；HIV RNA的预测因素包括检测到肛门直肠HIV DNA、肛门直肠炎症以及高血浆HIV RNA水平。当在肛门直肠样本中未检测到HIV DNA（如HIV感染细胞）时，后者（>10,000拷贝/毫升）是肛门直肠HIV RNA脱落的主要决定因素。在血浆HIV RNA载量低（<10,000拷贝/毫升）的人群中，HIV感染细胞的局部存在和局部炎症是HIV RNA的主要决定因素。在存在肛门直肠HIV DNA的人群中，血浆HIV RNA载量增加并不会增加HIV RNA脱落到肛管的风险。
