四川凉山州HIV感染者配偶阳转情况及影响因素分析

目的 了解凉山州艾滋病病毒感染者/艾滋病患者（HIV/AIDS）阴性配偶HIV血清阳转率及影响因素。方法 于 2009年1月1日—2019年12月31日，在HIV/AIDS的阴性配偶中进行回顾性队列研究，进行HIV检测及危险行为调查，采用Cox比例风险模型分析HIV感染配偶抗体阳转率的影响因素。结果 共纳入7 989名HIV感染配偶，总观察人时7 291.24人年，随访期间217名HIV感染配偶发生血清阳转，血清阳转率为2.98/100人年。多因素分析显示，文化程度小学以下（aHR = 1.86）、HIV/AIDS患者为女性（aHR = 2.13）、年龄≤35岁（aHR = 1.38）、确证感染时间＜1年(aHR = 3.74)、夫妻间性行为频率＞4次/月（aHR = 1.37）、病毒载量≥400拷贝/ml（aHR = 1.57）、近一次CD4细胞计数＜200个/μl（aHR = 1.81）是HIV感染配偶抗体阳转的危险因素，抗病毒治疗3年以上（aHR = 0.69）是HIV感染配偶抗体阳转的保护因素。结论 凉山州HIV感染配偶抗体阳转率处于较高水平，性行为频次高、文化程度低、年龄≤35岁、HIV/AIDS患者为女性、诊断感染时间＜1年、病毒载量400拷贝/ml以上、近一次CD4细胞计数＜200个/μl是HIV感染配偶抗体阳转的影响因素。

Analysis on the status and influencing factors of seroconversion in spouses of HIV-infected patients in Liangshan Prefecture,Sichuan Province

Objective To understand the HIV seroconversion rate of HIV-negative spouses of people living with HIV/AIDS in Liangshan Prefecture and the influencing factors. Methods A retrospective cohort study was conducted among HIV-negative spouses with HIV/AIDS from January 1, 2009 to December 31, 2019, with HIV testing and risk behavior surveys, and Cox proportional risk models were used to analyze the factors influencing the rate of antibody positive conversion in HIV-infected spouses. Results A total of 7 989 HIV-infected spouses were included, with a total observed person-time of 7 291.24 person-years. In total 217 HIV-infected spouses reported seroconversion during the follow-up period, and the seroconversion rate was 2.98 per 100 person-years. Multifactorial analyses showed that having less than elementary school education( aHR=1.86), being female with HIV/AIDS(a HR=2.13), age ≤35 years(aHR=1.38), confirmed infection <1 year(aHR=3.74),frequency of sexual intercourse between couples >4 times/month(aHR=1.37), viral load ≥400 copies/ml(aHR=1.57), recent CD4 cell count <200 cells/μl(aHR=1.81) were risk factors for positive antibody conversion in HIV-infected spouses, and antiviral treatment for more than 3 years(aHR=0.69) was a protective factor for positive antibody conversion in HIV-infected spouses. Conclusion The rate of positive conversion of HIV-infected spouses’ antibodies in Liangshan Prefecture is at a high level, and high frequency of sexual intercourse, low literacy, age ≤35 years, female HIV/AIDS patients, time to diagnosis of infection <1 year, viral load of 400 copies/ml or more, and recent CD4 cell count <200 cells/μl are the influencing factors for positive conversion of HIV-infected spouses’ antibodies.