云南省德宏州HIV单阳家庭感染者及阳转配偶特征  

Characteristics of HIV-infected persons and their spouses who became HIV-positive in HIV discordant couples in Dehong Prefecture,Yunnan Province

作　　者：李艳玲 何淑娴 曹艳芬 项丽芬 龚渝蓉 杨跃诚 叶润华 唐仁海 丁盈盈[2] 何纳[2] 段松 LI Yanling;HE Shuxian;CAO Yanfen;XIANG Lifen;GONG Yurong;YANG Yuecheng;YE Runhua;TANG Renhai;DING Yingying;HE Na;DUAN Song(Department for AIDS and STD Prevention and Control,Dehong Dai and Jingpo Autonomous Prefecture Center for DiseaseControl and Prevention,Mangshi,Yunnan 678400,China;School of Public Health,Fudan University,Key Laboratory ofPublic Health Safety of Ministry of Education,Shanghai 200032,China)

机构地区：[1]德宏傣族景颇族自治州疾病预防控制中心艾滋病性病防制科,云南芒市678400 [2]复旦大学公共卫生学院,公共卫生安全教育部重点实验室,上海200032

出　　处：《上海预防医学》2023年第12期1175-1180,共6页Shanghai Journal of Preventive Medicine

基　　金：国家科技重大专项(2018ZX10721102-004)。

摘　　要：【目的】了解云南省德宏傣族景颇族自治州(简称“德宏州”)人类免疫缺陷病毒(HIV)单阳家庭的阴性配偶发生阳转的55个家庭中先感染者和阳转配偶的基本特征、病毒载量、免疫状况以及发生HIV阳转的原因。【方法】从中国疾病预防控制信息系统的艾滋病(AIDS)综合防治数据信息系统中筛选出2015—2021年符合标准的既往配偶检测阳性的疫情卡片,共55对夫妻。收集一般社会人口学信息、确诊年龄、接触史、CD4+T淋巴细胞计数以及抗病毒治疗等资料。采用描述性分析描述先阳配偶和阳转配偶的分布情况,并进行χ2检验。【结果】共有55个HIV单阳家庭的阴性配偶发生HIV阳转,先阳配偶中男性占72.7%(40/55)。阳转配偶确诊时先阳配偶最近一次CD4+T淋巴细胞计数为(328.31±246.27)个·μL^(-1),<200个·μL^(-1)的占36.4%(20/55)。其中,病毒载量检测低于最低检测限的占45.0%(9/20),<400拷贝·mL^(-1)的占15.0%(3/20),≥400拷贝·mL^(-1)的占25.0%(5/20)。16.4%(9/55)的先阳配偶未检测病毒载量。单阳家庭中阴性配偶发生HIV阳转的主要原因是安全套使用情况欠佳、先阳配偶抗病毒治疗依从性差、出现治疗脱失等情况。【结论】应加强对德宏州HIV单阳家庭的随访管理,特别应加强先阳配偶的病毒载量水平和免疫状况监测,提高其抗病毒治疗的依从性,减少治疗脱失,从而更加有效地预防和控制HIV在夫妻间传播。[Objective]To determine the characteristics,viral load and immunological status of HIV-infected persons and their spouses who became HIV-positive,and the reasons for HIV seroconversion in 55 HIV discordant couples in Dehong Dai and Jingpo Autonomous Prefecture(Dehong Prefecture),Yunan Province.[Methods]Data on the 55 couples meeting the criteria of having a previously positive spouse were retrieved from the AIDS Integrated Prevention and Control Data Information System of the China Disease Control and Prevention Information System during 2015−2021.General socio-demographic information,age at diagnosis,exposure history,CD4+T lymphocyte count,and antiviral treatment were collected.Descriptive analysis and chi-square test were used to compare the distribution of pre-HIV-positive spouses and their HIV seroconverted spouses.[Results]A total of 55 spouses from HIV discordant couples had HIV seroconversion.Of them,72.7%(40/55)of pre-HIV-positive spouses were husbands.The most recent CD4+T lymphocyte count in the pre-HIV-positive spouses was(328.31±246.27)cells·μL^(-1) at the time of diagnosis of their seroconverted spouses,of which 36.3%(20/55)had a CD4+T lymphocyte count of less than 200 cells·μL^(-1).Furthermore,of those pre-HIV-positive spouses with low CD4+T lymphocyte count,45.0%(9/20)had an undetectable viral load,15.0%(3/20)<400 copies·mL^(-1),and 25.0%(5/20)≥400 copies·mL^(-1).Additionally,16.4%(9/55)of the pre-HIV-positive spouses did not have a viral load test.The main reasons for HIV seroconversion among HIV-negative spouses in the discordant couples were poor condom use,poor compliance with antiviral therapy,and treatment discontinuation.[Conclusion]The follow-up management of HIV discordant couples should be strengthened in Dehong Prefecture,especially the monitoring of viral load levels and immunological status of pre-HIVpositive spouses,to improve their compliance with antiviral therapy and reduce treatment discontinuation,which would effectively prevent and control HIV transmission between spo

关 键 词：艾滋病 HIV单阳家庭 阳转 夫妻间传播 病毒载量 免疫状况 

分 类 号：R183[医药卫生—流行病学] R512.91[医药卫生—公共卫生与预防医学]