新疆HIV单阳家庭阴性配偶血清阳转情况及影响因素分析  

Incidence and risk factors of HIV sero-conversion among serodiscordant couples in Xinjiang

作　　者：倪永康 周军 陈学玲[2] 马媛媛[2] 胡晓远[2] 刘早玲 NI Yong-kang;ZHOU Jun;CHEN Xue-ling(Department of Epidemiology and Health Statistics, College of Public Health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region 830011, China)

机构地区：[1]新疆医科大学公共卫生学院流行病与卫生统计学教研室,新疆乌鲁木齐830011 [2]新疆维吾尔自治区疾病预防控制中心

出　　处：《中国公共卫生》2018年第12期1577-1580,共4页Chinese Journal of Public Health

基　　金：国家科技重大专项(2013ZX10004907;2011ZX10001-001;2009ZX10001-019)

摘　　要：目的了解新疆艾滋病病毒(HIV)单阳家庭阴性配偶血清阳转情况,探讨其影响因素,为遏制艾滋病在单阳家庭间传播,实施高危行为干预提供理论依据。方法于2010年1月—2015年3月在新疆招募HIV单阳家庭阴性配偶,建立前瞻性队列,每3个月进行1次定位随访,每6个月进行1次血清学检测及危险行为调查,计算人年血清阳转率;利用Cox比例风险模型分析HIV单阳家庭阴性配偶血清阳转的影响因素。结果共纳入1 162名单阳家庭阴性配偶,总观察人时为2 496.23人年,随访期间42名阴性配偶发生血清阳转,血清阳转率为1.68/100人年。多因素分析显示,近6个月性行为频次> 2次/月(aHR=2.48,95%CI=1.22～5.02,P=0.012)、先证者最近1次CD^+T淋巴细胞计数<200个/μL (aHR=2.88,95%CI=1.37～6.08,P=0.006)是单阳家庭阴性配偶血清阳转的危险因素;坚持使用安全套(aHR=0.32,95%CI=0.16～0.63,P=0.003)、知晓HIV的传播途径(aHR=0.20,95%CI=0.07～0.60,P=0.004)是单阳家庭阴性配偶血清阳转的保护因素。结论新疆HIV单阳家庭阴性配偶的血清阳转率仍处于较高水平,应进一步在单阳家庭内推广安全套的使用,加大艾滋病相关知识宣传力度。Objective To explore incidence and influencing factors of human immunodeficiency virus(HIV)seroconversion among serodiscordant couples in Xinjiang Uygur Autonomous Region(Xinjiang)and to provide a theoretical basis for implementing intervention on high-risk behavior to prevent HIV transmission among serodiscordant couples.Methods We recruited HIV serodiscordant couples in Xinjiang between January 2010 and March 2015 for a prospective cohort study. A every 3-month follow-up and every 6-month serological test plus interview on high risk behaviors were conducted among the participants of the study. The seroconversion rate by person years was calculated and Cox proportional hazard model was used to examine the influencing factors of HIV seroconversion.Results For a total of 2 496.23 person years' follow-up upon 1 162 HIV negative individuals among the serodiscordant couples recruited, 42 HIV seroconversions were identified and the seroconversion rate was 1.68/100 person-years. Multivariate analysis revealed that having intercourse more than twice per month during previous 6 months(adjusted hazard risk [aHR]=2.48, 95% confidence interval[95% CI]: 1.22-5.02;P=0.012)and the propositus' latest CD4 cell count being less than 200/μL(aHR=2.88, 95% CI: 1.37-6.08;P=0.006)were the risk factors of HIV seroconversion;whereas, continuous condom using(aHR=0.32, 95% CI: 0.16-0.63;P=0.003)and being aware of the transmission route of HIV(aHR=0.20, 95% CI: 0.07-0.60;P=0.004)were protective factors against HIV seroconversion.Conclusion The HIV seroconversion rate is high among serodiscordant couples in Xinjiang, suggesting that condom use and health education on HIVrelated knowledge should be promoted among the serodiscordant couples.

关 键 词：HIV单阳家庭 血清阳转 前瞻性队列研究 

分 类 号：R512.91[医药卫生—内科学]