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在四个撒哈拉以南非洲国家的结核病患者家庭中,对艾滋病毒血清不同夫妇的模拟估计

Meixin Zhang¹, Ashley S Tseng^2,3, Godwin Anguzu^4,5

¹Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America.

PLOS global public health

|May 2, 2024

概括

家庭结核病接触评估可以识别艾滋病毒-血清不同的夫妇,增加口服预暴露预防 (PrEP) 的吸收. 这一战略可以在高负担国家每年防止成千上万的艾滋病毒感染.

科学领域:

流行病学流行病学
公共卫生公共卫生
预防传染病预防传染病

背景情况:

结核病 (TB) 和艾滋病毒具有共同的流行病学联系,这表明了综合预防策略的潜力.
家庭结核病接触者评估是一个关键的公共卫生干预措施.
口服暴露前预防 (PrEP) 是一种有效的艾滋病毒预防方法.

研究的目的:

估计四个高负担国家的结核病影响家庭中HIV血清不同夫妇的数量.
量化这些夫妇使用PrEP可以避免的潜在艾滋病毒感染.
评估将PrEP交付纳入结核病接触评估中的可行性.

主要方法:

基于模型的分析使用来自家庭调查,系统文献评论,元分析和2019年全球疾病,伤害和风险因素负担研究的数据.
马尔科夫链蒙特卡洛方法,以参数化不同血清夫妇与艾滋病毒流行率之间的关系.
在数学模型中不确定性传播的蒙特卡洛方法.

主要成果:

与埃塞俄比亚,肯尼亚,南非和乌干达的普通人口相比,结核病影响家庭的成年人 (15-49岁) 的艾滋病毒患病率更高.
艾滋病毒血清不同夫妇的比例在受结核病影响的家庭中明显高于一般人口中.
在受结核病影响的家庭中的不同血清组夫妇中,每年通过PrEP可预防的HIV感染:南非 (1,799),肯尼亚 (918),乌干达 (686),埃塞俄比亚 (408).

结论:

受结核病影响的家庭拥有更高比例的HIV血清异性夫妇,代表了预防艾滋病毒的关键人口.
将口服PrEP交付纳入家庭结核病接触评估是避免大量艾滋病毒感染的有希望的策略.
这种综合方法可以提高结核病和艾滋病毒预防工作的效率.

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