Nicoll A, Stephenson J, Griffioen A, Cliffe S, Rogers P, Boisson E
HIV and STD Division, Public Health Laboratory Service Communicable Disease Surveillance Centre, London, UK.
AIDS. 1998 Oct 1;12(14):1861-7. doi: 10.1097/00002030-199814000-00018.
To devise and validate a method for adjusting HIV seroprevalences in pregnant women to estimate population prevalences among all women in their child-bearing years.
Birth and termination rates from women with known HIV infection in the United Kingdom were calculated according to the likely route of HIV infection and whether HIV infection was diagnosed.
Birth and termination rates were weighted and combined to produce summary statistics. Comparisons were then made with population birth and termination rates to derive summary relative inclusion ratios (RIRs), the relative probabilities of including HIV-infected and uninfected women in seroprevalence surveys of pregnant women.
The derived RIRs for women having live births were close to unity: 1.03 [95% confidence intervals (CI) 0.90-1.17] for London and 0.80 (Cl, 0.71-0.89) for elsewhere in England and Wales. This indicates that currently observed overall seroprevalences among pregnant women having live births in London would be similar to those among all women of the same age, while elsewhere it would be slightly underestimated. Sensitivity analysis indicated that RIRs could, however, vary three-fold (0.47-1.56) according to the proportion of diagnosed maternal infections and the mix of maternal HIV-exposure categories. The method was validated by using it to predict the ratio of unlinked seroprevalences between women having terminations and live births in London. It predicted a ratio of 1.74: 1, which is close to the observed ratio of 2.07 : 1.
Application of HIV seroprevalences from pregnant women to whole populations may need adjustment for fertility rates among HIV-infected women. A general method for this has been derived and validated. Gathering fertility data for HIV-infected women is a useful adjunct to serosurveillance.
设计并验证一种调整孕妇HIV血清流行率的方法，以估计育龄期所有女性中的人群流行率。
根据HIV感染的可能途径以及是否诊断出HIV感染，计算英国已知感染HIV的女性的出生率和终止妊娠率。
对出生率和终止妊娠率进行加权并合并，以得出汇总统计数据。然后将其与人群出生率和终止妊娠率进行比较，以得出汇总相对纳入率（RIR），即在孕妇血清流行率调查中纳入HIV感染和未感染女性的相对概率。
活产女性的推导RIR接近1：伦敦为1.03 [95%置信区间（CI）0.90 - 1.17]，英格兰和威尔士其他地区为0.80（CI，0.71 - 0.89）。这表明，目前在伦敦观察到的活产孕妇总体血清流行率与同年龄所有女性的血清流行率相似，而在其他地区则会略有低估。敏感性分析表明，然而，根据确诊的孕产妇感染比例和孕产妇HIV暴露类别组合，RIR可能会有三倍的变化（0.47 - 1.56）。该方法通过用于预测伦敦终止妊娠和活产女性之间未关联血清流行率的比率进行了验证。它预测的比率为1.74：1，接近观察到的2.07：1的比率。
将孕妇的HIV血清流行率应用于整个人口可能需要根据HIV感染女性的生育率进行调整。为此已推导并验证了一种通用方法。收集HIV感染女性的生育数据是血清监测的有用辅助手段。
