新疆伊犁州HIV单阳家庭阳转率及其影响因素分析  

Analysis on HIV sero- conversion rate and influencing factors among single HIV-infected family in Yili Kazakh Autonomous Prefecture,Xinjiang

作　　者：崔燕[1] 张静[2] 陈学玲[1] 胡晓远[1] 马媛媛[1] 曾长玉 倪明健[1] 

机构地区：[1]新疆维吾尔自治区疾病预防控制中心,新疆乌鲁木齐830011 [2]新疆医科大学公共卫生学院,新疆乌鲁木齐830054

出　　处：《中国妇幼保健》2016年第15期3140-3143,共4页Maternal and Child Health Care of China

基　　金：国家科技重大专项(2013ZX10004907)

摘　　要：目的了解新疆伊犁州人类免疫缺陷病毒（HIV）单阳家庭阴性配偶的阳转情况及其影响因素。方法收集分析当地2009-2015年6月艾滋病综合防治信息系统中的HIV单阳家庭的随访信息，包括阳性配偶的人口学信息、健康状况以及阴性配偶的血清学信息。采用Kaplan-Meier和Cox比例风险模型进行单因素和多因素分析。结果1602户HIV单阳家庭中，58例阴性配偶HIV血清学阳转，平均阳转时间为1．8人年，总阳转率为1．58／100人年。Cox分析结果显示：阳性配偶WHO临床分期为Ⅲ期（HR=5．793，95％CI：2．506～13．392）、Ⅳ期（HR=10．569，95％CI：3．735～29．909）及感染性病（HR=3．665，95％CI：1．285—10．453）是配偶感染HIV的危险因素；抗病毒治疗时间〉1年（HR：0．535，95％CI：0．315～0．910）、最近一次CD4＋细胞检测〉350个／mm^3（HR=0．548，95％CI：0．327～0．918）是配偶感染HIV的保护因素。结论近年来新疆伊犁州HIV单阳家庭阳转水平趋于稳定并有所下降。今后的随访管理工作应加强性病筛查和治疗；扩大抗病毒治疗的覆盖面，定期监测CD4＋细胞水平和病毒载量水平。Objective To investigate HIV sero-eonversion rate of HIV negative couple and influencing factors among single HIV-inleered family in Yili Kazakh Autonomous Prefecture, Xinjiang. Methods The follow-up data of single-HIV infected family was collected from AIDS comprehensive prevention and treatment information system from 2009 to June 2015, then the data was analyzed, including demo- graphic information and health status of HIV-infeeted partner and serological information of HIV negative partner. Kaplan-Meier and Cox proportional hazard mode] were used for univariate and multivariate analysis. Results Among 1 602 single-HIV infected families, 58 HIV sero-conversion spouses were identified, and the mean sero-eonversion rate was 1.58 per 100 person-year. The results of Cox analysis showed that WHO clinical stage Ⅲ （HR=5.793, 95% CI： 2.506-13.392）, stage IV （HR=10.569, 95% CI： 3.735-29.909）, STD patients （HR=3. 665, 95% CI： 1. 285-10. 453 ） were risk factors. Initiation of antiviral therapy more than one year （HR = 0. 535, 95% CI： 0. 315-0. 910）, the last recorded CD4＋ cell count〉350 cells per mm3 （HR=0. 548, 95% CI： 0. 327-0. 918） were protective factors. Conclusion In recent years, the sero-conversion rate stabilized among single-HIV infected families in Yili, and it was lower than previous levels. In the future, the work of follow-up management should be strengthened in aspects of sexually transmitted diseases screening and treatment, the coverage of antiretroviral therapy should be enlarged, CD4＋ cells levels and viral load should be monitored regularly.

关 键 词：HIV单阳家庭 阳转率 影响因素 

分 类 号：R512.91[医药卫生—内科学]