艾滋病抗病毒治疗对配偶间人类免疫缺陷病毒传播的影响分析

发布时间：2018-04-06 00:01

本文选题：艾滋病　切入点：抗病毒治疗　出处：《中国现代医学杂志》2017年03期

【摘要】：目的了解艾滋病抗病毒治疗对单阳配偶间人类免疫缺陷病毒(HIV)传播的影响。方法采取回顾性队列研究的方法,选择百色市2005~2014年797例艾滋病患者及其未感染HIV的配偶为研究对象,根据患者接受抗病毒治疗状态分为治疗组和未治疗组随访观察阴性配偶的HIV转归,按患者不同年随访时间和基线特征分别计算阴性配偶每100人年HIV阳转率,并运用COX比例风险模型来评估治疗的风险比,运用KaplanMeier分析HIV阴性配偶仍保持阴性的概率。结果在HIV血清结果不一致的797例阳性配偶中,治疗组与未治疗组患者分别为487例和310例,平均年龄分别为(41.234±12.326)和(36.903±12.267)岁,基线CD4~+T淋巴细胞计数分别为(222.856±145.112)和(514.900±233.792)个/mm~3,中位随访时间分别为29(IQR:15~46)和31个月(IQR:18~52),两组均以男性、18~44岁、高中以下化程度、已婚、农民及农民工、壮族和异性性途径感染为主。随访期间共33例阴性配偶发生HIV阳转,阳转率为1.414/100人年,其中治疗组HIV阳转12例,阳转率为0.881/100人年,非治疗组HIV阳转21例,阳转率为2.159/100人年,经抗病毒治疗后配偶间HIV传播的危险性降低68.2%[AHR=0.318,(95%CI:0.125,0.807)],但抗病毒治疗对配偶间HIV传播的保护性作用有统计学意义仅是随访的第2年[AHR=0.157,(95%CI:0.031,0.786)]。结论在当前社会环境下,抗病毒治疗对预防配偶间HIV传播作用显著,但这种保护作用的持久性在桂西少数民族山区乃至发展中国家仍需进一步观察和研究,才能更好地推广治疗即预防的公共卫生策略。
[Abstract]:Objective to investigate the effect of HIV / AIDS antiviral therapy on HIV transmission between single positive spouses.Methods A retrospective cohort study was conducted on 797 AIDS patients and their uninfected spouses from 2005 to 2014 in Baise City.According to the state of antiviral therapy, the patients were divided into treatment group and untreated group to observe the HIV outcome of negative spouse. The positive rate of HIV was calculated according to the follow-up time and baseline characteristics of the patients.COX proportional risk model was used to evaluate the risk ratio of treatment and KaplanMeier was used to analyze the probability of HIV negative spouses remaining negative.Results among the 797 positive spouses with inconsistent results in HIV serum, 487 and 310 patients in the treatment group and the untreated group had a mean age of 41.234 卤12.326 and 36.903 卤12.267 years, respectively.During the follow-up period, 33 negative spouses had HIV positive conversion, with a positive conversion rate of 1.414 / 100 person-years. In the treatment group, 12 patients had HIV positive conversion, and the positive conversion rate was 0.881a / 100 person-years. In the non-treatment group, 21 patients had HIV positive conversion, and the positive conversion rate was 2.159p / 100 person-years.The risk of transmission of HIV between spouses was reduced by 68.2% after antiviral therapy [AHR 0.318U 95 CI: 0.125% 0.807], but the protective effect of antiviral therapy on HIV transmission between spouses was only the second year of follow-up [HIV 0.157% 95% CI0.031 0.786].Conclusion in the current social environment, antiviral therapy plays a significant role in preventing the transmission of HIV between spouses, but the persistence of this protective effect needs further observation and study in the mountain areas of minority nationalities in western Guangxi and even in developing countries.In order to better promote treatment and prevention of public health strategies.
【作者单位】：广西壮族自治区百色市疾病预防控制中心艾滋病科;广西壮族自治区百色市卫生监督所;右江民族医学院公共卫生与管理学院;
【基金】：广西壮族自治区百色市科技计划(No:140801-3)
【分类号】：R512.91

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