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PLoS med:性传播寨卡病毒和其它虫媒病毒

2018-08-14 MedSci MedSci原创

2015-2017年寨卡病毒爆发后,美国和欧洲的卫生部门报告了越来越多与旅行相关的寨卡病毒(ZIKV)传播事件。这一发现以及其他科学证据表明,除了主要通过蚊子传播的途径外,ZIKV还可经性传播。

在本研究中,研究人员定义了ZIKV性传播的7要素,包括 (1)直肠和阴道感染的易感性,(2) 性传播后的潜伏期 (3) 在中小学感染者连续出现症状之间的间隔,(4)传染性持续时间,(5)繁殖数量,(6)每次性行为传播的概率及(7)传输速率。

实验室实验证实直肠和阴道粘膜易受ZIKV感染,睾丸是动物模型中病毒的主要集中场所。在36对人类夫妇中报告了性传播,其中34/36为男女之间的性传播。15对夫妇的连续症状发作间隔中位数为12(四分位数范围:10-14.5),最长是44天。从2个预期队列中发现证据,ZIKV RNA存在于人类精液中,平均持续时间为34(95% CI: 28-41)35(没有CI给出)(根据等级,证据的确定性较低)。从37份病例报告和病例系列中检测到的ZIKV RNA的汇总数据显示,ZIKV的检测时间中位数为40(95% CI: 30-49),精液中最长检测时间为370天。在人类阴道液中,中位持续时间为14(95% CI: 7-20),最大持续时间为37(确定性非常低)。在人类精液中检测到传染性病毒,平均持续时间为12(95% CI: 1-21),最长69天。建模研究表明,繁殖数量低于1(确定性非常低)。目前缺乏证据来估计潜伏期或传播率。其他黄病毒性传播的证据也很少。由于不受控制的偏倚,证据的确定性是有限的。ZIKV更可能容易从男性传播到女性而不是从女性传播到男性。对于其他黄病毒,性传播的证据仍然缺乏。局域培养基中以及从序列间隔中检测ZIKV的所有可用数据,我们的发现表明,ZIKV的性传播感染期比最早的暴发后研究(仅基于逆转录PCR)估计的要短。

原始出处:

Counotte, Kim, Wang, Bernstein, Deal, Broutet, Sexual transmission of Zika virus and other flaviviruses: A living systematic review. PLoS medicine 15(7) e1002611.

本文系梅斯医学(MedSci)原创编译整理,转载需授权


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    2018-08-15 深海的鱼

    学习学习学习学习

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    2018-08-14 易水河

    知之为知之!

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