| 唐林,凌倩,陈方方,李培龙,葛琳,蔡畅,汤后林,吕繁,李东民.反向计算法估计红河哈尼族彝族自治州HIV新发感染趋势[J].中华流行病学杂志,2020,41(11):1876-1881 |
| 反向计算法估计红河哈尼族彝族自治州HIV新发感染趋势 |
| Estimation of newly HIV infection trend by using the back-calculation method in Honghe Hani and Yi autonomous prefecture |
| 收稿日期:2020-03-17 出版日期:2020-11-25 |
| DOI：10.3760/cma.j.cn112338-20200317-00369 |
| 中文关键词: CD4+T淋巴细胞 反向计算法 诊断延误权重 艾滋病病毒 新感染者 |
| 英文关键词: CD4+ lymphocytes Back-calculation method Diagnosis delay weight HIV Newly infection |
| 基金项目:国家科技重大专项（2017ZX10201101-002-005） |
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| 中文摘要: |
| 目的 根据HIV/AIDS的CD4+ T淋巴细胞计数（CD4）的变化规律，估计红河哈尼族彝族自治州（红河州）HIV新发感染者数，为评估当地的疫情流行趋势提供依据。方法 利用红河州HIV/AIDS抗病毒治疗前CD4数据，建立CD4平方根与感染时间的消除模型，反向估计HIV感染者的感染时间，并利用直接概率法和寿命表法计算累计诊断率分布以及诊断延误权重，推算研究地区历年HIV新发感染者数。结果 截至2018年12月31日，估计红河州HIV感染者数为35 977例，诊断发现率约为77.50%，其中2008-2018年HIV感染者数为23 792例，从2008年的2 602例逐年下降至2018年的1 480例，2007年及以前的新感染HIV人数为12 185例；其诊断延误权重从1年内的5.49下降至20年内的1.00，诊断率从1年的18.2%上升至20年的100.0%。结论 红河州HIV新发感染者数呈逐年下降趋势，诊断发现率距“第一个90%”目标仍有差距，扩大检测及时发现隐藏的HIV感染者有助于降低HIV传播风险。 |
| 英文摘要: |
| Objective Using the changing patterns of CD4+ lymphocytes (CD4) counts of HIV/AIDS cases, we tried to estimate the number of newly infected HIV in Honghe Hani and Yi autonomous prefecture (Honghe prefecture) Yunnan province, and to provide reference for evaluating the trend of local HIV epidemic. Methods Among diagnosed HIV infections, those who were at ≥15 years old, having available initial CD4 records of testing, initiating antiviral therapy before the end of 2018, were selected from the case reporting system of Honghe prefecture, Yunnan province. Both Depletion model of the square root on CD4 and the time of infection were used to back-calculate the seroconversion time of each individual. Both direct probability distribution method and life table method were used to calculate the distribution rates of diagnosis and the weight of delay. The number of diagnoses over the years was used to reversely estimate the total number of newly HIV infections. Results At the end of 2018, the total number of HIV infections was estimated 35 977 with the rate of diagnosis as 77.50% in Honghe prefecture of Yunnan province. The number of new HIV infections appeared as 23 792 in 2008-2018. Cumulatively, the number of new HIV infections was 12 185 up to 2007. The estimated number of new HIV infections decreased from 2 602 in 2008 to 1 480 in 2018. The weight of diagnostic delay decreased from 5.49 in one year to 1.00 in 20 years, and the diagnosis rate increased from 18.2% to 100.0% during 20 years. Conclusion In Honghe prefecture of Yunnan province, the number of newly infection showed a declining trend but the diagnostic rate was still far from reaching the “first 90% target”. It is expected to expand the timeliness on detection and case-finding so as to reduce the risk of HIV transmission. |
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