期刊
JOURNAL OF INFECTIOUS DISEASES
卷 203, 期 4, 页码 442-451出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/infdis/jiq085
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资金
- National Institutes of Health, National Institute of Allergy and Infectious Diseases [AI41532, AI41531, AI41535, AI43638, AI41535 AI57005, AI41536, AI43271, AI41530, AI41534, AI52403, AI57005]
Background. It is unknown whether sex and race influence clinical outcomes following primary human immunodeficiency virus type 1 (HIV-1) infection. Methods. Data were evaluated from an observational, multicenter, primarily North American cohort of HIV-1 seroconverters. Results. Of 2277 seroconverters, 5.4% were women. At enrollment, women averaged .40 log(10) fewer copies/mL of HIV-1 RNA (P < .001) and 66 more CD4(+) T cells/mu L (P = .006) than men, controlling for age and race. Antiretroviral therapy (ART) was less likely to be initiated at any time point by nonwhite women and men compared to white men (P < .005), and by individuals from the southern United States compared to others (P = .047). Sex and race did not affect responses to ART after 6 months (P > .73). Women were 2.17-fold more likely than men to experience > 1 HIV/AIDS-related event (P < .001). Nonwhite women were most likely to experience an HIV/AIDS-related event compared to all others (P = .035), after adjusting for intravenous drug use and ART. Eight years after diagnosis, > 1 HIV/AIDS-related event had occurred in 78% of nonwhites and 37% of whites from the southern United States, and 24% of whites and 17% of nonwhites from other regions (P < .001). Conclusions. Despite more favorable clinical parameters initially, female HIV-1-seroconverters had worse outcomes than did male seroconverters. Elevated morbidity was associated with being nonwhite and residing in the southern United States.
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