抗病毒治疗阻断HIV单阳家庭内传播效果的Meta分析

发布时间：2018-04-02 14:06

本文选题：艾滋病病毒　切入点：抗病毒治疗　出处：《中国艾滋病性病》2015年08期

【摘要】：目的通过Meta分析,了解抗病毒治疗(ART)阻断艾滋病病毒(HIV)单阳家庭内传播的效果。方法系统检索PubMed、Ovid、Web of science、Cochrane Central Register of Controlled Trials、CNKI、万方、维普等数据库,检索时间为1987年1月至2014年8月,纳入有关HIV阳性配偶ART阻断家庭内传播的文献,评价指标为家庭内传播的相对危险度(RR)。采用Stata软件进行异质性检验,计算合并RR值及其95%可信区间(CI)值,并根据性别、CD+4T淋巴细胞(简称CD4细胞)水平及国家收入水平进行亚组分析。结果共纳入16篇文献,包括1篇随机对照试验研究和15篇队列研究。Meta分析显示:ART阻断单阳家庭内传播的合并效应量RR=0.36(95%CI:0.26~0.50),表明与没有接受ART的单阳家庭相比,ART使HIV家庭内传播风险降低64%。亚组分析显示,与未治疗组相比,ART可使单阳家庭内男传女、女传男的风险分别降低63%和25%;在CD4细胞200个/μL、200~350个/μL、350个/μL时开始ART治疗,家庭内传播的风险分别降低74%、34%和59%;ART使中低收入国家和高收入国家人群的HIV家庭内传播风险分别降低66%和27%。结论抗病毒治疗可以降低HIV单阳家庭内传播的风险。并且对男传女的阻断效果优于女传男的家庭;当CD4细胞350个/μL或者200个/μL时,开始治疗的阻断效果优于CD4细胞200~350个/μL时;中低收入国家人群的阻断效果优于高收入国家。
[Abstract]:Objective to investigate the effect of antiviral therapy (ART) on the interfamily transmission of HIV / AIDS by Meta analysis.Methods We systematically searched the database of Central of science Central Register of Controlled trialsof CNKI, Wanfang, Weip, etc. From January 1987 to August 2014, we included the literature about HIV positive spouse ART to block the family transmission. The evaluation index was the relative risk of intrafamily transmission.The combined RR value and 95% CI value were calculated by using Stata software, and the subgroup analysis of CD4T lymphocyte (CD4 cell) level and national income level was carried out according to sex.Results A total of 16 articles were included.A randomized controlled trial study and 15 cohort studies. Meta-analysis showed that the combined effect of 1: art blocking transmission within a single positive family was 0.36 / 95 CI: 0.26 / 0.50, which indicated that art reduced the risk of intrafamily transmission of HIV by 64% compared with that of single positive family that did not accept ART.The subgroup analysis showed that art could reduce the risk of male to female transmission by 63% and female transmission to male by 63% and 25% respectively compared with untreated group, and began ART therapy at 200 渭 L ~ 350 渭 L and 350 渭 L / 渭 L of CD4 cells.The risk of intrahousehold transmission was reduced by 74% and 59%, respectively, and the risk of transmission within HIV was reduced by 66% and 27% in low and middle income countries and high income countries, respectively.Conclusion antiviral therapy can reduce the risk of intrafamilial transmission of HIV.When CD4 cells were 350 / 渭 L or 200 / 渭 L, the blocking effect of initial treatment was better than that of CD4 cells 200 ~ 350 / 渭 L, and the blocking effect of middle and low income countries was better than that of high income countries.
【作者单位】：北京大学公共卫生学院;
【基金】：国家十二五重大专项“我国艾滋病流行趋势、疫情评估和预测数学模型研究”(2012ZX10001001)~~
【分类号】：R512.91

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