深圳市人类免疫缺陷病毒感染初治者梅毒螺旋体共感染率及影响因素

目的探讨深圳市初治人类免疫缺陷病毒（HIV）感染者梅毒螺旋体共感染率及其高危因素。 方法以2015年1月至2018年12月深圳市第三人民医院收治的未接受过抗逆转录病毒治疗（ART）的成年HIV感染者作为研究对象,收集其临床资料,分析纳入研究对象的梅毒螺旋体共感染率。采用多变量Logistic回归模型分析HIV和梅毒螺旋体共感染的影响因素。 结果共纳入4 493例初治HIV感染者,梅毒螺旋体共感染率为19.72%（886/4 493）。男性和女性HIV感染者梅毒螺旋体合并感染率分别为20.96%（872/4 160）和4.20%（14/333）,差异有统计学意义（χ² = 54.690、P < 0.001）。HIV合并梅毒螺旋体感染者中RPR滴度≥ 1︰8者占62.75%（556/886）。不同RPR滴度患者异常ALT（χ² = 3.353、P = 0.851）、AST（χ² = 7.791、P = 0.351）和TB（χ² = 8.957、P = 0.256）比例差异均无统计学意义。多因素Logistic回归分析显示,男性（OR = 4.876、95%CI：2.770～8.583、P < 0.001）、同性传播感染HIV（OR = 1.307、95%CI：1.077～1.585、P = 0.007）、确诊至初治时间> 12个月（OR = 1.360、95%CI：1.115～1.657、P = 0.002）、抗-HCV阳性（OR = 2.728、95%CI：1.252～5.945、P = 0.012）均为HIV感染者合并梅毒螺旋体感染的危险因素。 结论深圳市初治HIV感染者合并梅毒螺旋体感染率较高,尤其男性、男男同性感染HIV、HIV确诊至初治时间超过12个月、抗-HCV阳性者为合并梅毒螺旋体感染的高风险人群,建议在HIV感染人群中加强梅毒螺旋体感染防控相关健康教育,并常规进行梅毒螺旋体筛查。

Rate and influencing factors of patients with human immunodeficiency virus coinfected with syphilis in Shenzhen

ObjectiveTo investigate the co-infection rate and high-risk factors of syphilis among the initially treated patients with human immunodeficiency virus (HIV) infection in Shenzhen. MethodsThe clinical data of adult patients with HIV infection without antiretroviral therapy (ART) in Shenzhen Third People’s Hospital from 2015 Junuary to 2018 December were collected, and the co-infection rate of syphilis of patients with HIV infection were anayzed. The influencing factors of co-infection of syphilis and HIV were analyzed by multivariate Logistic regression model. ResultsTotal of 4 493 patients with HIV infection were included, the co-infection rate of syphilis was 19.72% (886/4 493). The co-infection rate of syphilis among male and female patients with HIV infection were 20.96% (872/4 160) and 4.20% (14/333), respectively, with significant difference (χ² = 54.690, P < 0.001). Patients of HIV and syphilis co-infection and rapid plasma reagin circle test (RPR) titer higher than 1︰8 accounted for 62.75% (556/886). The proportion of abnormal ALT (χ² = 3.353, P = 0.851), AST (χ² = 7.791, P = 0.351) and TB (χ² = 8.957, P = 0.256) of patients with different RPR titers were not significant different. Multi-factor Logistic regression analysis showed that male (OR = 4.876, 95%CI: 2.770-8.583, P < 0.001), men who have sex with men (MSM) transmission of HIV (OR = 1.307, 95%CI: 1.077-1.585, P = 0.007), the time of diagnosis to initial treatment longer than 12 months (OR = 1.360, 95%CI: 1.115-1.657, P = 0.002), anti-HCV positive (OR = 2.728, 95%CI: 1.252-5.945, P = 0.012) were risk factors to HIV-infected patients coinfected with syphilis, all with significant differences. ConclusionsThe rate of HIV-infected patients coinfected with syphilis was high in Shenzhen, especially male, HIV infected through MSM, the time of diagnosis to initial treatment longer than 12 months, anti-HCV positive were high-risk population. It was recommended to strengthen the health education of syphilis prevention and control in patients with HIV-infection, and also routine screening for syphilis.