HIV-1夫妻间传播的回顾性队列研究

目的研究艾滋病病毒Ⅰ型（HIV-1）的夫妻间传播率，为预防控制性传播提供科学依据。方法在某农村地区，2000—2007年陆续发现的110对配偶-方为HIV-1感染者，均为1990—1997年间-次性输血而感染，无其他感染因素，感染后与配偶无保护性生活7．51年，感染者的配偶否认除夫妻无保护性传播以外的艾滋病传播因素。对感染者配偶用酶联免疫吸附试验和免疫印迹试验（Western—blot）检测HIV抗体。结果HIV-1的夫妻间传播率为17．3％，年均传播率为2．3％。其中妻子传给丈夫的概率为19．1％，平均年感染机率2．7％；丈夫传给妻子的概率为9．5％，平均年感染机率1．1％。无保护性生活时间越长、妻子感染时丈夫的年龄越小感染率越高，测算夫妻间每次无保护性交的感染机率为0．024％～0．032％。HIV阳性妻子每次无保护性交传染给丈夫的机率是0．028％～0．037％；HIV阳性丈夫每次无保护性交传染给妻子的机率是0．011％～0．015％。结论在夫妻-方感染日期明确、夫妻无保护性生活年限明确的情况下，得到的HIV-1的夫妻传播率，对预防控制艾滋病性传播具有重要的指导意义。

Retrospective cohort study on transmission of human immunodeficiency virus type 1 between spouses

Objective To study the transmission rate of human immunodeficiency virus type Ⅰ （HIV-1） between wives and husbands and provide scientific data for the prevention and control of HIV sexual transmission. Methods One hundred and ten married couples in a rural area were surveyed between 2000 and 2007,of whom either husbands or wives were infected with HIV-1 through one- time blood transfusion from 1990 to 1997. They denied other ways of HIV trans- mission,but admitted having unprotected sex between them in the past 7 years after the infection. Their serum specimens were tested for HIV-1 antibody by ELISA and Western-blot. Results Transmission rate of HIV-1 between spouses was 17.3 % and the average annual transmission rate was 2.3 %, of which 19.1% were from wives to husbands with an aver- age annual probability of 2.7 % and 9.5 % were vice verse with an average annual probability of 1.1%. The longer un- protected sex between the spouses and the younger husbands when wives got infected with HIV-1, the higher transmission rate between them. It was calculated that the probability of infection due to unprotected sex between the spouses was 0. 024 % - 0. 032 % ; the probability of transmission to husbands by infected wives through each unprotected sex was 0.028% -0. 037%, while that to wives by infected husbands through each unprotected sex was 0. 011% -0. 015 %. Conclusion The HIV-1 transmission rate between spouses will have important significance for the prevention and control of HIV/AIDS infection only if the date when either husbands or wives get infected is clear and the length of unprotected sex between them is made known.