中国中部农村艾滋病病毒感染状况不一致夫妻的随访研究

李敬云; 李林; 李宏; 鲍作义; 李韩平; 王哲; 庄道民; 刘永健; 刘思扬

Abstract

李敬云,李林,李宏,鲍作义,李韩平,王哲,庄道民,刘永健,刘思扬.中国中部农村艾滋病病毒感染状况不一致夫妻的随访研究[J].Chinese journal of Epidemiology,2006,27(3):192-195

中国中部农村艾滋病病毒感染状况不一致夫妻的随访研究

Cohort study on human immunodef iciency virus discordant couples in the countryside of central China

Received:September 01, 2005

DOI：

KeyWord: 艾滋病病毒异性性传播艾滋病病毒感染状况不一致夫妻

English Key Word: Human immunodeficiency virus Heterosexual transmission Human immunodeficiency virus discordant couples

FundProject:国家“十五”科技攻关资助项目(2004BA719A01)

Author Name	Affiliation
LI Jing-yun	State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
LI Lin	State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
LI Hong	河南省疾病预防控制中心
BAO Zuo-yi	State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
LI Han-ping	State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
WANG Zhe	河南省疾病预防控制中心
ZHUANG Dao-min	State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
LIU Yong-jian	State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
LIU Si-yang	State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China

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Abstract:

目的在河南省某地农村建立艾滋病病毒(HIV)感染状况不一致(DC)的夫妻队列并进行随访, 观察HIV通过异性性传播的频率及其影响因素。方法通过访谈和血清学检测, 确定了52对(一方HIV阳性而另一方阴性但无吸毒、性乱、输血等HIV感染危险行为)夫妻进入研究队列, 在0.5、1和2.5年进行3次随访, 每次随访均询问夫妻双方的性生活和安全套使用情况, 同时抽取20ml抗凝静脉血检测HIV抗体、CD4+T淋巴细胞计数以及病毒载量。结果 (1)0.5、1和2.5年的随访率分别是92.3%、75.0%和28.8%。在随访的过程中, DC夫妻中HIV阴性一方HIV抗体始终保持阴性, 未出现HIV抗体阳转及HIV的传播。 (2)在队列建立时(0年)以及0.5、1和2.5年随访时, DC夫妻性生活次数每月1次至每周1次的分别占65.4%、72.9%、71.7%和80.0%, 有时使用或从来不用安全套的比例分别是76.9%、66.6%、69.1%和60.0%, 不同随访时间性生活次数和安全套使用频率的差异无统计学意义。(3)DC夫妻中的HIV阳性一方在0.5、1和2.5年随访时,CD4⁺T淋巴细胞计数保持稳定或上升的比例分别是85.4%、66.6%和60.0%。15对在2.5年随访到双方的夫妻,HIV阳性一方中病毒载量稳定和下降的占66.7%, 绝大部分病毒载量保持稳定或下降者同时CD4⁺T淋巴细胞计数也保持稳定或上升。结论研究中未观察到HIV在夫妻之间的传播。HIV阳性一方稳定的病毒载量和CD4⁺T细胞计数可能是HIV未发生传播的原因之一, 宿主的遗传免疫学因素以及HIV的生物学特性对传播的影响值得深入研究。

English Abstract:

Objective To establish a cohort of human immunodeficiency virus ( HIV) discordant couples for follow-up studies and to collect data on frequency of HIV heterosexual transmission and related factors. Methods A total of 52 HIV discordant couples were identified by face to face interview and serological testing,in which the HIV negative individuals had no HIV infection behaviors including injecting drug use,blood transfusion or having sexual partners other than his/her own wife/husband. Three times of follows-up studies were carried out in 0.5 year,1 year and 2.5 years to collect information on their sexual practices and condom use through face to face interview together with 20 ml whole blood collected to test HIV antibody,CD4+T cell count and viral load. Results (1) In the period of 2.5 years follow-up,no HIV seroconversion and HIV transmission was found. (2) The frequencies of sexual intercourse between once per month to once per week were 65.4 %,72.9%,71.7 % and 80.0% at the time of cohort setup : 0.5 year,1 year and 2. 5 years of follow2up respectively. The rates of“occasional use”to“never use”condoms were 76.9%,66.6%,69.1% and 60.0% at the time of cohort setup as : 0.5 year,1 year and 2.5 years of follow2up,respectively. No significant difference between different times of follow2up for sexual intercourse or condom use. (3) 85.4%,66.6% and 60.0% of the HIV positive individuals kept their CD4⁺T cell count stabilized or raised during the 0.5 year, 1 year and 2. 5 years follow-up period, respectively. Howedver, 66.7% of them showed stable or declined viral load in the period of 2.5 years follow-up. It appeared that stable or raised CD4⁺T cell and the stable or declined viral load happened simultaneously. Conclusion　No transmission was identified in this study. The stabilized CD4⁺T cell count and viral load might be account for the reason of no transmission while the biological factors from host and virus related with transmission need to be further studied.

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