广州市2008-2009年新报告HIV感染者/AIDS病人溯源调查分析  被引量:9

A source tracing survey of newly reported HIV/AIDS cases in 2008-2009 in Guangzhou

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作  者:李燕[1] 陈绮珊[1] 梁颖茹[1] 高凯[1] 陈远[2] 徐慧芳[1] 

机构地区:[1]广州市疾病预防控制中心,广东广州510080 [2]中国疾病预防控制中心性病艾滋病预防控制中心,北京100050

出  处:《中国艾滋病性病》2011年第2期131-134,共4页Chinese Journal of Aids & STD

基  金:"HIV抗体不确定"病例有关生物学因素研究(广东省卫生厅;A2009563);广州市医药卫生科技项目(2009-YB-130)~~

摘  要:目的掌握艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(HIV/AIDS病人)的高危行为接触者(简称"接触者")的感染来源及二代传播等情况,并探讨发现新HIV/AIDS病人手段的有效性和可行性。方法对2008年8-10月和2009年5-8月新报告的HIV/AIDS病人及其接触者进行追踪溯源调查。结果两年溯源调查试点期间报告HIV/AIDS病人346例,完成溯源调查的224例(占64.74%),136例(60.71%)完成了CD4检测,完成溯源调查的病人68.30%(153/224)为性传播,其中异性性行为传播(61.44%,94/153)高于男男同性性行为(38.56%,59/153)。非固定性行为传播(72.54%,111/153)高于固定性行为(27.45%,42/153),非商业性行为传播(70.59%,108/153)高于商业性行为(29.41%,45/153)。溯源调查发现新HIV/AIDS的效率为9.88%,明显高于自愿咨询检测(VCT)(2.79%)。经进化树分析,绝大多数原代病例的病毒与其对应的阳性接触者的病毒具有同源性,部分病例与其原代病例的病毒不具有同源性。结论溯源调查发现新病例的效率高,但是对接触者进行追踪调查的难度大,尤其是商业性伴、婚外性伴;流行病学调查结合分子生物学方法来综合分析感染来源,能更明确地揭示HIV的传播规律。Objective To trace the source and the secondary transmission of HIV by investigating newly reported HIV/AIDS cases in 2008-2009 in Guangzhou,and evaluate the effectiveness and feasibility of such survey as a new strategy for further case detection.Method The HIV/AIDS cases diagnosed from August through October of 2008 and from May through August of 2009 were surveyed,the information of their risk behaviors and close contacts were obtained,and the close contacts were traced to explore their infectious status.Results During the 2 year survey 346 HIV/AIDS cases were reported,and source tracing survey was completed for 224 cases(64.74%),of whom 136 cases were tested for CD4(81.44%).The survey showed that the majority of HIV/AIDS cases(153/224,68.30%) were infected via sexual transmission,and the heterosexual behaviors(61.44%,94/153)were higher than male homosexual behaviors(38.56%,59/153),sexual behaviors with casual partners(72.54%,111/153) were higher than those with regular partners(27.45%,42/153,and non-commercial sexual behaviors(70.59%,108/153) were higher than commercial ones(29.41%,45/153;the efficiency of detecting new HIV/AIDS cases in the survey was 9.88%,significantly higher than that in VCT service(2.79%).Phylogenetic analysis showed that the majority of the first generation HIV/AIDS cases and their matching HIV-positive contacts had the same HIV subtype and genetic homology,and only some of them did not have genetic homology with the HIV positive contacts.Conclusion The source tracing survey is highly efficient to detect new HIV/AIDS cases,much higher than VCT service,but it is difficult to trace the risk contacts,especially commercial sex partners and extramarital/casual sex partners.Epidemiological survey combined with molecular biotechnology will better elucidate the sources of infection,and so will more help to clearly understand the transmission status.

关 键 词:艾滋病病毒感染者/艾滋病病人 溯源调查 

分 类 号:R373.9[医药卫生—病原生物学] R512.91[医药卫生—基础医学]

 

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