首页   按字顺浏览 期刊浏览 卷期浏览 Role of the Primary Infection in Epidemics of HIV Infection in Gay Cohorts
Role of the Primary Infection in Epidemics of HIV Infection in Gay Cohorts

 

作者: John Jacquez,   James Koopman,   Carl Simon,   Ira Longini,  

 

期刊: Journal of Acquired Immune Deficiency Syndromes  (OVID Available online 1994)
卷期: Volume 7, issue 11  

页码: 1169-1184

 

ISSN:0894-9255

 

年代: 1994

 

出版商: OVID

 

关键词: HIV;Primary infection;Basic reproduction number;Behavior change;Core groups

 

数据来源: OVID

 

摘要:

A review of the data on infectivity per contact for transmission of the HIV suggests that the infectivity may be on the order of 0.1–0.3 per anal intercourse in the period of the initial infection, 10-4to 10-3in the long asymptomatic period, and 10-3to 10-2in the period leading into AIDS. The pattern of high contagiousness during the primary infection followed by a large drop in infectiousness may explain the pattern of epidemic spread seen in male homosexual cohorts in the early years of the epidemic. Simulations of cohorts of homosexual males, using that range of parameter values, indicate the following: (a) The initial fast rise and then more or less rapid flattening of the incidence curve of seropositives is primarily due to rapid initial spread, yielding a group of infecteds all of whom pass into the low infectivity asymptomatic period at close to the same time. All this occurs only if the basic reproduction number for the primary infection is > 1. (b) The behavioral changes that have been reported all started after the incidence of new infections began to fall, too late to have a major effect on the initial rise. The behavioral changes had a major effect in slowing down the subsequent rise in the number of seropositives. (c) High activity groups play an important role in the early rapid rise of the epidemic. However, it is not likely that the rapid decrease in rate of growth of seropositives is solely due to saturation of these very high activity groups. Although the evidence for this interpretation of the role of the primary infection is not conclusive, its implications for prevention and for vaccine trials are so markedly different from those of other interpretations that we consider it to be an important hypothesis for further testing.

 

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