| 朱秋映,杨小艺,江河,谭广杰,熊润松,廖玲洁,邢辉,阮玉华,沈智勇,唐振柱,邵一鸣.抗病毒治疗对广西壮族自治区HIV单阳家庭阴性配偶抗体阳转的预防效果[J].Chinese journal of Epidemiology,2015,36(12):1401-1405 |
| 抗病毒治疗对广西壮族自治区HIV单阳家庭阴性配偶抗体阳转的预防效果 |
| Efficacy of antiviral therapy on prevention of HIV transmission among sero-discordant couples in Guangxi Zhuang autonomous region |
| Received:May 07, 2015 |
| DOI：10.3760/cma.j.issn.0254-6450.2015.12.019 |
| KeyWord: 艾滋病病毒 抗病毒治疗 单阳家庭 预防效果 |
| English Key Word: HIV Antiviral therapy Sero-discordant couples Preventive effect |
| FundProject:广西八桂学者艾滋病防控关键技术岗位专项经费 |
| Author Name | Affiliation | E-mail | | Zhu Qiuying | HIV/AIDS Prevention and Control Institute, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530021, China | | | Yang Xiaoyi | HIV/AIDS Prevention and Control Institute, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530021, China
Epidemiology and Health Statistics Teaching and Research Section, Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University | | | Jiang He | HIV/AIDS Prevention and Control Institute, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530021, China | | | Tan Guangjie | HIV/AIDS Prevention and Control Institute, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530021, China | | | Xiong Runsong | HIV/AIDS Prevention and Control Institute, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530021, China | | | Liao Lingjie | HIV/AIDS Prevention and Control Institute, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530021, China | | | Xing Hui | HIV/AIDS Prevention and Control Institute, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530021, China | | | Ruan Yuhua | HIV/AIDS Prevention and Control Institute, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530021, China | | | Shen Zhiyong | HIV/AIDS Prevention and Control Institute, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530021, China | shenzhiyong99999@sina.com | | Tang Zhenzhu | HIV/AIDS Prevention and Control Institute, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530021, China | | | Shao Yiming | HIV/AIDS Prevention and Control Institute, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530021, China
Epidemiology and Health Statistics Teaching and Research Section, Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University | |
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| Abstract: |
| 目的 了解抗病毒治疗(ART)对HIV单阳家庭阴性配偶抗体阳转的预防效果。方法 以2008年1月1日至2014年12月31日广西壮族自治区(广西)所有上报到艾滋病综合防治数据信息管理系统的HIV单阳家庭为研究对象,采用时间相依协变量Cox模型分析ART对阴性配偶HIV抗体阳转的预防效果。结果 共纳入7 694个HIV单阳家庭,其中394个家庭的阴性配偶发生HIV抗体阳转。总HIV抗体阳转率为2.5/100人年(95%CI:2.2/100人年～2.7/100人年),其中未治疗队列阳转率为4.3/100人年(95%CI:3.7/100人年～4.8/100人年),治疗队列阳转率为1.6/100人年(95%CI:1.4/100人年～1.9/100人年)。ART对HIV单阳配偶抗体阳转的预防效果为51%(HR=0.49,95%CI:0.40～0.60),调整性别、年龄、文化程度、婚姻状况、职业、感染途径、基线CD4+T淋巴细胞后预防效果为45%(AHR=0.55,95%CI:0.43～0.69)。ART对年龄≥25岁、初中及以下学历、已婚、农民、基线CD4+T淋巴细胞<500 cells/mm3、通过异性途径感染的先证者阴性配偶血清抗体阳转的预防效果有统计学意义。结论 ART作为广西HIV单阳家庭的一项干预措施是可行且有效的,扩大HIV单阳家庭ART的覆盖面有利于降低HIV夫妻间的传播。 |
| English Abstract: |
| Objective To understand the efficacy of antiviral therapy on prevention of HIV transmission and to assess the feasibility of treatment-as-prevention strategy in public health practice, among sero-discordant couples in Guangxi Zhuang autonomous region(Guangxi). Methods Data was gathered through the AIDS prevention and control information system in Guangxi from January 1, 2008 to December 31, 2014, on HIV sero-discordant couples. Time-dependent Cox Model was used to analyze the efficacy of antiviral treatment. Results A total of 7 694 sero-discordant couples were followed and 394 appeared positive from those negative spouses. The overall HIV positive seroconversion rate was 2.5(2.2-2.7)/100 person-year. The HIV positive sero-conversion rates were 4.3(3.7-4.8)/100 person-year in the untreated cohort and 1.6(1.4-1.9) per 100 person-year in the treated cohort. Rate of HIV transmission declined by 51% in the treated cohort (HR=0.49, 95%CI: 0.40-0.60) but appeared as 45% (AHR=0.55, 95%CI:0.43-0.69) after adjusting for factors as sex, age, education, marital status, occupation, transmission route and baseline CD4+T lymphocyte cell count. The rate of reduction in transmission was significant among couples in which the HIV-positive spouses showing the following features as: aged ≥25 years, married, farmers, with educational level of junior high school or below, baseline CD4+T lymphocyte cell count <500 cells/mm3 and infection was through heterosexual intercourse. Conclusion Antiviral therapy as a prevention strategy among sero-discordant couples seemed feasible and effective in Guangxi. Expansion of the coverage on antiviral therapy would reduce the spread of HIV in married couples. |
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