四川省吸毒人群艾滋病病毒和梅毒新发感染的队列研究

尹潞; 秦光明; 阮玉华; 张莉; 郝沁宁; 陈显煌; 姜正清; 宋本莉; 刘石柱; 曹晓蕴; 郝春; 陈康林; 邵一鸣

Abstract

尹潞,秦光明,阮玉华,张莉,郝沁宁,陈显煌,姜正清,宋本莉,刘石柱,曹晓蕴,郝春,陈康林,邵一鸣.四川省吸毒人群艾滋病病毒和梅毒新发感染的队列研究[J].Chinese journal of Epidemiology,2006,27(4):293-297

四川省吸毒人群艾滋病病毒和梅毒新发感染的队列研究

A prospective cohort study on human immunodeficiency virus and syphilis seroconversion among injecting drug users

Received:November 25, 2005 Revised:November 25, 2005

DOI：

KeyWord: 艾滋病病毒梅毒静脉吸毒人群前瞻性队列研究

English Key Word: Human immunodeficiency virus Syphilis Injecting drug users Prospective cohort

FundProject:国家“十五”科技攻关课题项目(2004BA719A01 2004BA719A02);卫生部艾滋病防治应用性研究项目(WA2003-13);国家自然科学基金资助项目(30571612 10501052)

Author Name	Affiliation	E-mail
YIN Lu	100050 北京, 中国疾病预防控制中心性病艾滋病预防控制中心传染病预防控制国家重点实验室
QIN Guangming	四川省疾病预防控制中心
RUAN Yuhua	100050 北京, 中国疾病预防控制中心性病艾滋病预防控制中心传染病预防控制国家重点实验室
ZHANG Li	100050 北京, 中国疾病预防控制中心性病艾滋病预防控制中心传染病预防控制国家重点实验室
HAO Qinning	四川省凉山州西昌市皮肤病性病防治站
CHEN Xianhuang	四川省凉山州西昌市皮肤病性病防治站
JIANG Zhengqing	四川省凉山州西昌市皮肤病性病防治站
SONG Benli	四川省凉山州西昌市皮肤病性病防治站
LIU Shizhu	100050 北京, 中国疾病预防控制中心性病艾滋病预防控制中心传染病预防控制国家重点实验室
CAO Xiaoyun	100050 北京, 中国疾病预防控制中心性病艾滋病预防控制中心传染病预防控制国家重点实验室
HAO Chun	100050 北京, 中国疾病预防控制中心性病艾滋病预防控制中心传染病预防控制国家重点实验室
CHEN Kanglin	四川省凉山州西昌市皮肤病性病防治站
SHAO Yiming	100050 北京, 中国疾病预防控制中心性病艾滋病预防控制中心传染病预防控制国家重点实验室	yshao@bbn.cn

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Abstract:

目的调查四川省某地区静脉吸毒人群艾滋病病毒(HIV)和梅毒血清抗体阳转情况及其危险因素。方法 2002年11月在四川省西昌市以社区为基础招募HIV血清抗体阴性的静脉吸毒人群前瞻性研究队列333人,在队列每6个月随访时调查静脉吸毒人群高危吸毒行为和性行为情况, 并采集血样进行HIV和梅毒抗体检测。结果队列随访2年,静脉吸毒人群队列保持率和HIV血清抗体阳转率分别为75．7%和2．53/100人年(95%CI:1．10-3．97),在多因素Poisson回归模型分析中,民族(RR=12．42,95%CI:2．72-56．74,P=0．0012)、近3个月共用针头或注射器(RR=4．06, 95%CI:1．29-12．81,P=0．0168)与HIV血清抗体阳转的关系有统计学意义。该研究队列梅毒血清抗体阳转率为4．71/100人年(95%CI:2．59-6．82),在多因素Poisson回归模型中,女性(RR= 4．42,95%CI:1．78-10．99,P=0．0014)与梅毒血清抗体阳转的关系有统计学意义。结论该地区静脉吸毒人群HIV和梅毒新发感染率高,应采取有效的干预措施以控制HIV的传播流行。

English Abstract:

Objective To study the rate of human immunodeficiency virus(HIV) seroconversion, HIV transmission and related risk factors among injecting drug users(IDUs) in an area of Sichuan province. Methods In November 2002, a community-based baseline survey was conducted to recruit 333 HIV-seronegative IDUs for a prospective cohort study in Xichang county of Sichuan province, China. Follow-up visits were carried out every 6 months to study the situation of drug use, sexual behaviors of the IDUs and blood specimens were collected to test for antibodies against HIV and syphilis. Results During a 24-month follow-up period, cohort retention rate and HIV incidence were 75.7% and 2.53 per 100 person-years [95% confidence interval(CI) : 1.10-3.97)], respectively. Multivariate Poisson regression model showed that risk factors which were significantly associated with HIV seroconversion would include: ethnicity (RR=12.42; 95%CI: 2.72-56.74, P=0.0012) and needle or syringe sharing in the past 3 months (RR=4.06; 95%CI: 1. 29-12.81,P = 0.0168). Syphilis seroconversion in this cohort was 4.71 per 100 person-years (95% CI:2. 59-6.82). In multivariate Poisson regression being female (RR = 4.42; 95% CI:l.78-10.99, P= 0.0014) appeared to be the only factor which was significantly associated with syphilis seroconversion. Conclusion Our study results showed that there was a rapid transmission of HIV and syphilis among IDUs in Sichuan province, suggesting that effective intervention should be urgently taken.

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