云南省德宏州HIV感染者的阴性配偶中新发感染率研究

目的 了解德宏州HIV感染者的阴性配偶中HIV新发感染率.方法 2005年11月始在HIV感染者的阴性配偶中建立前瞻性队列,每6个月随访,进行问卷调查和HIV检测.结果 至2008年6月底共纳入研究对象790人,随访观察702人,2006-2008年随访期间发病密度为2.58/100人年,各年度发病密度分别为2.22/100人年、2.95/100人年、2.74/100人年.Cox回归模型结果显示,与发病风险有关的因素有:居住于盈江县风险比(HR)=4.37,95%CI:1.48～12.90,P=0.008 ]、有吸毒史(HR=3.49,95%CI:1.09～11.18,P=0.035)以及配偶(指感染者)未接受过抗病毒治疗(HR=3.60,95%CI:1.41～9.16,P=0.007).结论 德宏州HIV感染者的阴性配偶中HIV新发感染率较高,针对某些地区以及本人有吸毒史、或其HIV阳性配偶未接受抗病毒治疗的感染者配偶仍需加强HIV预防干预.

Incidence and risk factors of HIV infection among sero-negative spouses of HIV patients in Dehong prefecture of Yunnan province

Objective To study the HIV incidence and risk factors among sero-negative spouses of HIV patients in Dehong prefecture of Yunnan province. Methods A cohort of sero-negative spouses of the HIV patients had been developed and followed up since November, 2005.HIV new infections and related behaviors had been investigated every six months. Results By the end of June, 2008, 790 sero-negative spouses of HIV patients had been recruited, of whom 702 were followed-up for at least one time. During the total 1202.35 person-years, 31 new HIV infections were identified, with an overall incidence of 2.58/100 preson-years. The HIV incidence rates were 2.22/100person-years in 2006, 2.95/100 person-years in 2007 and 2.74/100 person-years in 2008. Data from the Cox proportional hazard regression model indicated that those who resided in Yingjiang county hazard ratio (HR) =4.37, 95% CI: 1.48-12.90, P=0.008] , ever using drugs (HR=3.49, 95% CI:1.09-11.18, P=0.035) , or having an HIV-infected spouse who never exposed to antiretroviraltreatment (HR=3.60, 95% CI: 1.41-9.16, P=0.007) were at higher risk for HIV infection.Conclusion Sero-negative spouses of HIV patients in Dehong prefecture of Yunnan province had a relatively high incidence of HIV new infection during 2006-2008. More efforts should put on those people living in these areas, having a history of drug use or having an HIV-infected spouse who had never been exposed to antiretroviral treatment.