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首页> 外文期刊>AIDS >Male circumcision and risk of male-to-female HIV-1 transmission: a multinational prospective study in African HIV-1-serodiscordant couples.
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Male circumcision and risk of male-to-female HIV-1 transmission: a multinational prospective study in African HIV-1-serodiscordant couples.

机译：男性包皮环切术和男女间HIV-1传播的风险：一项针对非洲HIV-1血清不一致的夫妇的跨国前瞻性研究。

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OBJECTIVE: Male circumcision reduces female-to-male HIV-1 transmission risk by approximately 60%. Data assessing the effect of circumcision on male-to-female HIV-1 transmission are conflicting, with one observational study among HIV-1-serodiscordant couples showing reduced transmission but a randomized trial suggesting no short-term benefit of circumcision. DESIGN/METHODS: Data collected as part of a prospective study among African HIV-1-serodiscordant couples were analyzed for the relationship between circumcision status of HIV-1-seropositive men and risk of HIV-1 acquisition among their female partners. Circumcision status was determined by physical examination. Cox proportional hazards analysis was used. RESULTS: A total of 1096 HIV-1-serodiscordant couples in which the male partner was HIV-1-infected were followed for a median of 18 months; 374 (34%) male partners were circumcised. Sixty-four female partners seroconverted to HIV-1 (incidence 3.8 per 100 person-years). Circumcision of the male partner was associated with a nonstatistically significant approximately 40% lower risk of HIV-1 acquisition by the female partner (hazard ratio 0.62, 95% confidence interval 0.35-1.10, P = 0.10). The magnitude of this effect was similar when restricted to the subset of HIV-1 transmission events confirmed by viral sequencing to have occurred within the partnership (n = 50, hazard ratio 0.57, P = 0.11), after adjustment for male partner plasma HIV-1 concentrations (hazard ratio 0.60, P = 0.13), and when excluding follow-up time for male partners who initiated antiretroviral therapy (hazard ratio 0.53, P = 0.07). CONCLUSION: Among HIV-1-serodiscordant couples in which the HIV-1-seropositive partner was male, we observed no increased risk and potentially decreased risk from circumcision on male-to-female transmission of HIV-1.
机译：目的：男性包皮环切术可将女性对男性的HIV-1传播风险降低约60％。评估包皮环切术对HIV-1男女传播的影响的数据相互矛盾，一项针对HIV-1血清不一致夫妇的观察研究显示，传播减少，但一项随机试验表明，包皮环切术没有短期益处。设计/方法：对在非洲HIV-1血清不一致的夫妇中进行的前瞻性研究的一部分数据进行了分析，以分析HIV-1血清阳性男性的包皮环切状况与女性伴侣中HIV-1感染风险之间的关系。包皮环切状态通过身体检查确定。使用Cox比例风险分析。结果：总共对1096例HIV-1血清不一致的夫妇进行了中位18个月的随访，其中男性伴侣被HIV-1感染。 374名（34％）男性伴侣被割礼。 64位女性伴侣血清转化为HIV-1（每100人年3.8的发生率）。男性伴侣的包皮环切术与女性伴侣感染HIV-1的风险具有非统计学意义的降低约40％（危险比0.62，95％置信区间0.35-1.10，P = 0.10）。当调整为男性伴侣血浆中的HIV-病毒后，如果仅限于通过病毒测序确认在伴侣关系中发生的HIV-1传播事件的子集（n = 50，危险比0.57，P = 0.11），则这种影响的程度相似。 1个浓度（危险比0.60，P = 0.13），并且不包括开始抗逆转录病毒治疗的男性伴侣的随访时间（危险比0.53，P = 0.07）。结论：在HIV-1血清阳性伴侣为男性的HIV-1血清不协调夫妇中，我们观察到包皮环切术对HIV-1的男女传播没有增加风险，也没有降低潜在风险。

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