云南省德宏州静脉注射毒品者HIV新发感染率及其危险因素研究

段松; 项丽芬; 杨跃诚; 叶润华; 贾曼红; 罗红兵; 傅丽茹; 宋丽军; 赵余仙; 杨建华; 王斌; 刘志远; 濮永成; 韩文香; 杨忠桔; 李维美; 王继宝; 朱炜明; 何纳

Abstract

段松,项丽芬,杨跃诚,叶润华,贾曼红,罗红兵,傅丽茹,宋丽军,赵余仙,杨建华,王斌,刘志远,濮永成,韩文香,杨忠桔,李维美,王继宝,朱炜明,何纳.云南省德宏州静脉注射毒品者HIV新发感染率及其危险因素研究[J].Chinese journal of Epidemiology,2009,30(12):1226-1229

云南省德宏州静脉注射毒品者HIV新发感染率及其危险因素研究

Incidence and risk factors on HIV infection among injection drug users in Dehong prefecture area of Yunnan province

Received:June 05, 2009

DOI：

KeyWord: 艾滋病病毒发病率静脉注射毒品者队列研究

English Key Word: Human immunodeficiency virus Incidence Injection drug users Cohort study

FundProject:国家自然科学基金资助项目(30271365)

Author Name	Affiliation	E-mail
DUAN Song	云南省德宏州疾病预防控制中心, 潞西 678400	nhe@shmu.edu.cn
XIANG Li-fen	云南省德宏州疾病预防控制中心, 潞西 678400
YANG Yue-cheng	云南省德宏州疾病预防控制中心, 潞西 678400
YE Run-hua	云南省德宏州疾病预防控制中心, 潞西 678400
JIA Man-hong	云南省疾病预防控制中心
LUO Hong-bing	云南省疾病预防控制中心
FU Li-ru	云南省疾病预防控制中心
SONG Li-jun	云南省疾病预防控制中心
ZHAO Yu-xian	盈江县疾病预防控制中心
YANG Jian-hua	盈江县疾病预防控制中心
WANG Bin	潞西市疾病顶防控制中心
LIU Zhi-yuan	潞西市疾病顶防控制中心
PU Yong-cheng	陇川县疾病预防控制中心
HAN Wen-xiang	陇川县疾病预防控制中心
YANG Zhong-jie	瑞丽市疾病预防控制中心
LI Wei-mei	梁河县疾病预防控制中心
WANG Ji-bao	云南省德宏州疾病预防控制中心, 潞西 678400
ZHU Wei-ming	复旦大学公共卫生学院流行病学教研室
HE Na	复旦大学公共卫生学院流行病学教研室

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Abstract:

目的了解云南省德宏州静脉注射毒品者(IDU)中HIV新发感染率及其危险因素.方法 2004年10月招募HIV检测阴性的245名IDU进入队列,启动IDU人群艾滋病流行病学队列研究,于2006年底进行第一次随访检测确定HIV发病率.自2007年1月起,不断纳入新发现的HIV阴性的IDU,扩大流行病学研究队列,并每半年进行一次有关毒品使用和性行为等暴露因素的随访调查,同时血清学检测确定HIV新发感染率.结果截止2008年底,共招募入组760名IDU,至少随访1次者有540人,累积观察1153.6人年,新发现HIV感染者47人,HIV新发感染率为4.07/100人年,其中2004-2006年为4.45/100人年,2007年为4.50/100人年,2008年为2.54/100人年.随访期间,研究对象中IDU比例和HIV新发感染率均有显著下降.Cox比例风险回归模型多因素分析显示,景颇族[风险比(HR)=2.56,95%CI:1.06～6.19]和除傣族以外的其他少数民族(HR=3.26,95%CI:0.89～11.96)的HIV感染风险高于汉族;随访期间注射毒品但未共针者(HR=2.27,95%CI:0.98～5.25)以及有共针注射毒品行为者(HR=5.27,95%CI:2.25～12.34)的HIV感染风险高于随访期间没有注射毒品者.结论云南省德宏州既往IDU人群中注射吸毒的比例和HIV新发感染率近4年来均呈现下降趋势.共用注射器吸毒仍是IDU人群HIV感染的最重要的危险因素,不同民族IDU的HIV感染风险不同.

English Abstract:

Objective To determine the incidence and risk factors on HIV infection among injection drug users(IDU)in Dehong prefecture area of Yunnan province.Methods An epidemiological cohort of HIV-negative IDU had been developed and followed since October,2004.HIV new infections and related behaviors had been investigated every six months.Results By the end of 2008,760 HIV-negative IDU had been recruited and followed for a total of 1153.6 person-years.47 new HIV infections were identified,with an overall incidence of 4.07/100 person-years during the follow-up period.The HIV incidence was 4.45/100 person-years during 2004-2006,4.50/100 person-years in 2007 and 2.54/100 person-years in 2008.Both the behavior of drug injection and the HIV incidence among the cohort had substantially decreased during the follow-up period.Multiple regression analysis using Cox proportional hazard model indicated that people with Jing-po ethnicity(Hazard ratio,HR=2.56,95% CI:1.06-6.19)and other minorities except for Dai(HR=3.26,95% CI:0.89-11.96)were at higher risk for HIV infection than the people with Han ethnicity.People injecting drugs with(HR=2.21,95%CI:0.98-5.25)or without(HR=5.27,95%CI:2.25-12.34)needle sharing were at higher risk for HIV infection than those reporting having no drug injection behavior during the follow-up period.Conclusion Both the behavior of drug injection and the HIV incidence among former IDU in Dehong prefecture area of Yunnan province had been decreasing during the four years.However,needle sharing remained the most important risk factor for HIV new infection among IDUs.IDUs with different ethnicities seemed to have different risks towards HIV infection.

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