男男性传播与异性性传播HIV新近感染者艾滋病疾病进展比较分析  

Comparative analysis of HIV progression between MSM with newly HIV infection and heterosexual transmission

作　　者：李世福[1] 董文斌[1] 蔡英[1] 付金翠[1] 高良敏[2] 

机构地区：[1]云南省玉溪市疾病预防控制中心,云南玉溪653100 [2]清华大学医学院公共健康中心,北京100008

出　　处：《现代预防医学》2018年第2期340-343,355,共5页Modern Preventive Medicine

摘　　要：目的对比分析HIV新近感染者中传播途径为男男性传播(MSM)者、异性性传播者的疾病进展情况,为MSM人群的艾滋病防治策略的制定提供依据。方法对玉溪市2006-2013年间新报告的MSM、异性性传播者HIV血清阳性样本用BED捕获酶免疫法(BED)判定HIV新近感染,进行3年及以上的队列研究,2组人群进行对比分析。结果 24例MSM和105例异性性传播HIV感染者BED判为新近感染,其基线CD4+T淋巴细胞计数中位数分别为475个/μl(IQR:304~555)和522个/μl(IQR:354~625),差异有统计学意义(t=-5.337,P<0.05),基线CD4+T淋巴细胞计数小于350个/μl的比例分别为33.33%和4.76%,差异有统计学意义(χ~2=14.586,P<0.05),同时2组人群月均CD4+T淋巴细胞计数自然变化速率分别为:-6.65和-1.14个/μl,差异有统计学意义(t=19.336,P<0.05)。在为期3年的队列研究中,新近感染者1年内CD4+T细胞计数即下降至350个/μl以下者占比分别为31.25%和6.00%,差异有统计学意义(χ~2=7.516,P<0.05)。结论玉溪市MSM人群HIV感染者CD4+T淋巴细胞计数下降速度较快,疾病进展快,需对该人群加强干预。Objective The aim of this study was to comparatively analyze the HIV-1 progression between man who have sex with man （MSM） with HIV infection and heterosexual transmission, in order to work out HIV prevention and therapeutic measures for the management department of AIDS. Methods Serum samples were collected by Yuxi centre for disease control and prevention between 2006 and 2013. The samples were defined as recently infected or long term by the BED-CEIA. And then 3 times regular follow-up cohort study was conducted. A statistical analysis was conducted for the MSM with HIV infection and heterosexual transmission. Results There were 24 cases of MSM and 105 cases of heterosexual transmission were defined as recently infected by the BED-CEIA, respectively. The median baseline CD4^＋T cell counts were 475cell/μL （IQR： 304-555） and 522 cell/μL （IQR： 354-625） （t=-5.337, P〈0.05） and the percentage of base line of CD4^＋T cell counts less than 350 cell/μL were 33.33% and 4.76%, respectively （χ^2 =14.586, P〈0.05）. There were differences between two groups, meanwhile, the average change rate of CD4^＋T cell counts were -6.65 and -1.14cell/μL in month respectively. There were differences between the two groups （t=19.336, P〈0.05）. In the three-years cohort study, the percentage of CD4^＋T cell counts depleted to less than 350 cell/μL of two groups, defined as recent were 31.25% and 6.00% in one year. There were differences between the two groups （χ^2 =7.516, P〈0.05）. Conclusion The MSM in Yuxi prefecture showed significant depletion of CD4^＋ T cell counts, resulting in a faster disease progression. The intervention should cover more MSM.

关 键 词：HIV感染者/艾滋病病人 男男性接触者 疾病进展 CD4^+T淋巴细胞计数 

分 类 号：R183[医药卫生—流行病学]