云南省德宏州艾滋病病毒感染者/艾滋病患者阴性配偶HIV新发感染研究

目的 了解云南省德宏州艾滋病病毒感染者/艾滋病患者(HIV/AIDS)阴性配偶HIV新发感染率及其危险因素。方法 2009年2月至2014年12月,在HIV/AIDS的阴性配偶中建立前瞻性队列,每年随访一次,进行问卷调查及HIV检测。结果 至2014年12月,共纳入研究对象2091例,其中1692例研究对象至少随访一次,34例研究对象新发感染HIV,累计观察时间为5494.52人年, HIV新发感染率为0.62/100人年。2009-2010、2011-2012、2013-2014年HIV新发感染率分别为0.79/100人年、0.62/100人年、0.47/100人年。Cox回归分析显示,HIV新发感染的危险因素为不坚持使用安全套(HR=4.64,95%CI:1.89~11.40,P=0.001);与阴性配偶入组时间相比,HIV/AIDS开始抗病毒治疗时间晚一年以上(HR=3.70,95%CI:1.44~9.49,P=0.007),HIV/AIDS未进行抗病毒治疗(HR=3.62,95%CI:1.14~11.51,P=0.029)。结论 德宏州HIV/AIDS阴性配偶中HIV新发感染率相对较低。仍需在阴性配偶人群中进一步宣传坚持使用安全套的重要性,并尽早对HIV/AIDS进行抗病毒治疗。

Incidence and risk factors of HIV infection among sero-negative spouses of people living with HIV/AIDS in Dehong prefecture, Yunnan province

Objective To study the incidence rate and risk factors of HIV infection among sero-negative spouses of people living with HIV/AIDS(HIV/AIDS) in Dehong prefecture, Yunnan province. Methods A prospective cohort study was conducted from February 2009 to December 2014 in Dehong prefecture, Yunnan province. Questionnaire survey and HIV related tests were carried out once a year. Results By the end of December 2014, 2091 sero-negative spouses had been recruited, of whom 1692 were followed-up for at least one time. Results showed that 34 new HIV infections were identified within 5494.52 person years of follow-up, for an overall incidence of 0.62 per 100 person years. HIV incidence rates appeared as 0.79 per 100 person years, 0.62 per 100 person years, 0.47 per 100 person years in 2009-2010, 2011-2012, 2013-2014, respectively. Data from the Cox proportional hazard regression model indicated that risk factors of HIV infection among sero-negative spouses of HIV/AIDS were:non-consistent condom use(HR=4.64, 95%CI:1.89-11.40, P=0.001), HIV/AIDS delayed antiviral retrovirus therapy(ART) for more than one year(HR=3.70, 95%CI:1.44-9.49, P=0.007) after the HIV negative spouses were initially recruited, HIV/AIDS did not receive any ART(HR=3.62, 95%CI:1.14-11.51, P=0.029). Conclusions The incidence of HIV infection among sero-negative spouses in Dehong prefecture was relatively low. Publicity on consistent condom use program should be emphasized among sero-negative spouses of HIV/AIDS, together with the timely provision of ART to those HIV/AIDS.