影响艾滋病病毒异性性传播有关因素的研究

李林; 李敬云; 鲍作义; 刘思扬; 庄道民; 刘永健; 冯福民

Abstract

李林,李敬云,鲍作义,刘思扬,庄道民,刘永健,冯福民.影响艾滋病病毒异性性传播有关因素的研究[J].Chinese journal of Epidemiology,2003,24(11):980-983

影响艾滋病病毒异性性传播有关因素的研究

Study on factors associated with heterosexual-transmission of human immunodeficiency virus in central China

Received:April 28, 2003

DOI：

KeyWord: 人类免疫缺陷病毒性传播病毒载量 CD4细胞计数

English Key Word: Human immunodeficiency virus Sexual-transmission Viralload CD4 cell count

FundProject:国家“十五”科技攻关课题资助项目(2001BA705B02)

Author Name	Affiliation
LI Lin	Institute of Microbiology and Epidemiology, Academy of Military Medical Science, Beijing 100071, China
LI Jing-yun	Institute of Microbiology and Epidemiology, Academy of Military Medical Science, Beijing 100071, China
BAO Zuo-y i	Institute of Microbiology and Epidemiology, Academy of Military Medical Science, Beijing 100071, China
LIU Si-yang	Institute of Microbiology and Epidemiology, Academy of Military Medical Science, Beijing 100071, China
ZHUANG Dao-min	Institute of Microbiology and Epidemiology, Academy of Military Medical Science, Beijing 100071, China
LIU Yong-jian	Institute of Microbiology and Epidemiology, Academy of Military Medical Science, Beijing 100071, China
FENG Fu-min	Institute of Microbiology and Epidemiology, Academy of Military Medical Science, Beijing 100071, China

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Abstract:

目的了解中国中部地区艾滋病病毒(HIV)异性性传播的特点及其影响因素.方法(1)现况研究:在中国河南、河北等省农村寻找至少一方HIV阳性、有稳定婚姻、年龄20～50岁的夫妻,由专业研究人员对其进行访谈,并采集夫妻双方抗凝全血样本20 ml,检测病毒载量、CD4/CD8细胞计数;(2)病例对照研究:以一方HIV阳性,通过性生活导致对方HIV感染的夫妻为病例,以一方HIV阳性、双方有正常的性生活,但对方未感染HIV的夫妻为对照, 进行病例对照研究.结果 (1)共收集到87对至少一方HIV阳性的夫妻,其中病例夫妻7对,对照夫妻56对,发生HIV性传播的夫妻占全部有性传播危险夫妻的11.1%;(2)在对照夫妻中,男方HIV阳性的14对,占25.0%,女方HIV阳性的42对,占75.0%;(3)病例组性生活次数≥4次/月的比例显著高于对照组(Fisher's检验,P=0.047,OR=8.0).病例组病毒载量≥105拷贝/ml的比例显著高于对照组(Fisher's检验,P=0.016,OR=22.0).病例组先感染一方的HIV病毒载量显著高于对照组的感染一方(t=3.591,P＜0.01)、而CD4细胞计数和CD4/CD8比值均显著低于对照组的感染一方(t=2.767,P＜0.05;t=6.06,P＜0.05).结论中国中部地区有稳定婚姻的夫妻中HIV异性性传播的频率可能很低.性生活次数多、感染一方的病毒载量高、CD4细胞计数和CD4/CD8比值较低预示较大的HIV性传播危险.

English Abstract:

Objective To investigate the factors of the human immunodeficiency virus (HIV) associated with sexual-transmission in central China.Methods ( 1) Cross-sectional study: couples thaTone was HIV positive were selectedin Henan and Hebei province of China. The couplesmusTbe 20-50 years old with normal function on sexual intercources.CordanTcouples thaTsubsequently infected partners were aTrisk of infection solely through sexual contacTwith the HIV-seropositive partner and the discordanTcouples thaTthe seronegative partners were aTrisk of infection solely through sexual contacTwith the HIV-seropositive partner, were selected.Plasma viralload, CD4 cell counTwere tested. ( 2)Case-control study was used to compare 7 sexual transmitted cases and56 nontransmittedcontrols with respecTto the frequency of sexual intercourses, plasma viralload and CD4 cell count. Results ( 1) A total of 87 couples thaTaTleasTone partner was HIV positive were recruited include 56 discordanTcouples and 7 cordanTcouples with whom sexual transmission had happend. The rate of sexual transmission was 11. 1% among those aTthe risk of sexual transmission. ( 2) Of the discordanTcouples, male positive rate 25%, female positive was 75%. ( 3) The risk for transmission was higher in those couples with the frequency of unprotected vaginal sexual intercourse (≥4 timesper month)than the reference group ( <4 timesper month)(Fisher' s exacTtest, P=0. 047, OR =8. 0).Median plasma viralload was significantly higher in the antecedenTinfected partners of cordanTcouples than the positive partner of discordanTcouples ( 378 285. 71 vs 136 578. 57 copies ml, t=3. 591, P<0. 01).The odds ratio was 22. 0 for plasma viralload ≥100 000 copies ml compared with the reference group of <100 000 copies ml( Fisher' s exacTtest, P =0. 016). The CD4 cell counTand CD4 CD8 of the transmitted group were significantlylower than thaTof the nontransmitted(T= 2. 767, P<0. 05; T=6. 06, P <0. 05).Conclusions The frequencies of heterosexual-transmission in central China were relativelylow.The risk of heterosexual transmission was related to the frequency of sexual intercources.Higher plasma viralload andlower CD4 counTwas strongly correlated with high risk of heterosexual transmission.

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