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Lancet：使用不同类型的注射孕激素避孕的女性与HIV-1的联系

2015-05-27 崔倩 译 MedSci原创

注射激素HIV-1
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背景: 一些观察性研究报道，使用长效醋酸甲羟孕酮（DMPA）避孕的女性的HIV-1获得风险比那些不使用激素避孕的女性要高。该研究的目的是评估是否两个注射孕激素避孕药，DMPA和庚炔诺酮（NET-EN），导致了HIV-1感染的不同风险。    方法: 在2009年9月9日到2012年8月13日之间，研究人员从南非中使用注射避孕的女性参与的VOICE研究中收集数据，这个多

背景: 一些观察性研究报道，使用长效醋酸甲羟孕酮（DMPA）避孕的女性的HIV-1获得风险比那些不使用激素避孕的女性要高。该研究的目的是评估是否两个注射孕激素避孕药，DMPA和庚炔诺酮（NET-EN），导致了HIV-1感染的不同风险。
    
方法: 在2009年9月9日到2012年8月13日之间，研究人员从南非中使用注射避孕的女性参与的VOICE研究中收集数据，这个多站点，随机，安慰剂对照试验，研究了三种配方替诺福韦预防HIV-1感染的安全性和有效性。每个月对这些女性避孕药的使用和感染情况进行评估。在这一前瞻性研究中，研究人员通过Cox比例风险回归分析评估了使用DMPA和NET-EN的患者HIV-1感染的差异。
    
结果: 3141名使用注射避孕的南非女性被纳入本次分析：1788名（56.9％）单独使用DMPA，1097名（34.9％）单独使用NET-EN，256名（8.2％）在随访过程中不同的时间使用这两种类型的注射。在2733例7年的随访期间，207例HIV-1感染的发生（发生率每100人年为7.57，95％Cl 6.61-8.68）。DMPA使用者HIV-1感染的风险（每100人年发病为8.62，95％Cl 7.35-10.11）比在NET-EN使用者要高（每100人年发病为5.67，4.35-7.38；风险比1.53，95％Cl 1.12-2.08，P=0.007）。当对潜在的混杂变量调整时该联系持续（调整后的危险比[aHR]1.41，95％Cl 1.06-1.89，P=0.02）。在招募时血清单纯疱疹病毒2型（HSV-2）阳性的女性，与HSV-2阴性的女性（1.09 0.78-1.52）相比，aHR是2.02（95％Cl 1.26-3.24）（Pinteraction=0.07）。
    
结论: 虽然这些观测分析中适度的联系应谨慎解释，但这些研究结果表明，NET-EN（HIV低风险）可能是DMPA（HIV-1高发病率）的一种替代注射药物。

原始出处:

Dr Lisa M Noguchi, PhDcorrespondenceemail, Prof Barbra A Richardson, PhD, Prof Jared M Baeten, MD, Prof Sharon L Hillier, PhD, Jennifer E Balkus, PhD, Prof Z Mike Chirenje, MD, Katherine Bunge, MD, Gita Ramjee, PhD, Gonasagrie Nair, MBChB, Thesla Palanee-Phillips, PhD, Pearl Selepe, MBChB, Prof Ariane van der Straten, PhD, Urvi M Parikh, PhD, Kailazarid Gomez, MPM, Jeanna M Piper, MD, D Heather Watts, MD, Prof Jeanne M Marrazzo, MD for the VOICE Study Team.Risk of HIV-1 acquisition among women who use different types of injectable progestin contraception in South Africa.Lancet,May 26, 2015.

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    2016-03-21 仁心济世

    #Lancet#

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1828120, encodeId=e63d1828120e2, content=<a href='/topic/show?id=1b6210686b2' target=_blank style='color:#2F92EE;'>#Lancet#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10686, encryptionId=1b6210686b2, topicName=Lancet)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Mon Mar 21 08:43:00 CST 2016, time=2016-03-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2068811, encodeId=c7d5206881157, content=<a href='/topic/show?id=9da3203482c' target=_blank style='color:#2F92EE;'>#不同类型#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=20348, encryptionId=9da3203482c, topicName=不同类型)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6e7948, createdName=李研东, createdTime=Sat Nov 14 10:43:00 CST 2015, time=2015-11-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=25613, encodeId=0b6f25613b7, content=看看, beContent=null, objectType=article, channel=null, level=null, likeNumber=134, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ee0d1618732, createdName=huaxipanxing, createdTime=Sun May 31 21:28:00 CST 2015, time=2015-05-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1385343, encodeId=43901385343a9, content=<a href='/topic/show?id=9aeb45318ed' target=_blank style='color:#2F92EE;'>#孕激素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45318, encryptionId=9aeb45318ed, topicName=孕激素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=05a2499, createdName=dzx0922889, createdTime=Fri May 29 01:43:00 CST 2015, time=2015-05-29, status=1, ipAttribution=)]
    2015-11-14 李研东

    #不同类型#

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    2015-05-31 huaxipanxing

    看看

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    2015-05-29 dzx0922889

    #孕激素#

    0