浙江省有HIV传播风险的HIV感染者梅毒感染情况及影响因素

何林; 潘晓红; 杨介者; 马瞧勤

Abstract

何林,潘晓红,杨介者,马瞧勤.浙江省有HIV传播风险的HIV感染者梅毒感染情况及影响因素[J].Chinese journal of Epidemiology,2023,44(9):1358-1362

浙江省有HIV传播风险的HIV感染者梅毒感染情况及影响因素

Prevalence of syphilis in HIV-infected patients with transmission risk and influencing factors in Zhejiang Province

Received:January 30, 2023

DOI：10.3760/cma.j.cn112338-20230130-00046

KeyWord: 艾滋病病毒传播风险梅毒

English Key Word: HIV Transmission risk Syphilis

FundProject:浙江省医药卫生科技计划（2023KY632，2021RC048）；浙江省基础公益研究计划（LGF18H260006）

Author Name	Affiliation	E-mail
He Lin	Institute of AIDS/STD Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
Pan Xiaohong	Institute of AIDS/STD Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China Zhejiang Association of STD/AIDS Prevention and Control, Hangzhou 310005, China	xhpan@cdc.zj.cn
Yang Jiezhe	Institute of AIDS/STD Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
Ma Qiaoqin	Institute of AIDS/STD Prevention and Control, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China Zhejiang Association of STD/AIDS Prevention and Control, Hangzhou 310005, China

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Abstract:

目的了解浙江省有HIV传播风险的HIV感染者梅毒感染情况及相关因素。方法资料来源于中国疾病预防控制信息系统截至2018年12月31日浙江省现存活、HIV确证时间>1年、未接受抗病毒治疗或HIV病毒载量≥50拷贝数/ml、年龄≥15岁的HIV感染者，收集其人口学特征、性行为特征、抗病毒治疗和梅毒血清学检测结果等信息，采用logistic回归模型分析梅毒感染及影响因素。采用SPSS 19.0软件进行统计学分析。结果浙江省HIV感染者中，2 275例有HIV传播风险，75.5%（1 717/2 275）进行了梅毒血清学检测，梅毒感染率为8.7%（150/1 717）。在梅毒感染的HIV感染者中，未接受抗病毒治疗占11.3%（17/150），病毒载量为50~999拷贝数/ml占38.7%（58/150）和≥1 000拷贝数/ml占50.0%（75/150）。多因素分析结果显示，男性（aOR=2.04，95%CI：1.06~3.96）、同性性传播（aOR=1.53，95%CI：1.04~2.27）、HIV确证前性病史（aOR=1.98，95%CI：1.35~2.92）和病毒载量≥1 000拷贝数/ml（aOR=1.90，95%CI：1.09~3.30）为梅毒感染危险因素，已婚（aOR=0.47，95%CI：0.29~0.76）是梅毒感染的保护因素。结论浙江省有HIV传播风险的HIV感染者的梅毒感染率较高，亟须开展HIV感染者分类管理和针对性强化干预，探索开展多病共防共治，加强HIV感染者梅毒筛查和治疗，降低HIV和梅毒传播风险。

English Abstract:

Objective To investigate the prevalence of syphilis in HIV-infected patients with transmission risk and influencing factors in Zhejiang Province. Method The information about the HIV-infected patients, who were alive, had been diagnosed with HIV for >1 year, had received no antiviral treatment or had HIV viral load ≥ 50 copies/ml, and were aged ≥ 15 years, reported in Zhejiang as of December 31, 2018 were collected from China Information System for Disease Control and Prevention. The information included general demographic characteristics, sexual behavior characteristics and antiretroviral therapy and syphilis serological test results. The prevalence of syphilis and the influencing factors were analyzed by logistic regression model. The SPSS 19.0 software was used for statistical analysis. Results A total of 2 275 HIV-infected patients were at risk of HIV transmission, and 75.5% (1 717/2 275) of them were tested for syphilis, the prevalence rate of syphilis was 8.7% (150/1 717). Among the HIV-infected patients with syphilis, 11.3% (17/150) received no antiviral treatment, 38.7% (58/150) had viral load of 50-999 copies/ml and 50.0% (75/150) had ≥ 1 000 copies/ml. Multivariate logistic regression analysis showed that being men (aOR=2.04, 95%CI:1.06-3.96), homosexual transmission (aOR=1.53, 95%CI:1.04-2.27), history of sexually transmitted diseases (STDs) before HIV diagnosis (aOR=1.98, 95%CI:1.35-2.92) and HIV viral load ≥ 1 000 copies/ml (aOR=1.90, 95%CI:1.09-3.30) were the risk factors for syphilis. Marriage (aOR=0.47, 95%CI:0.29-0.76) was a protective factor for syphilis. Conclusions The prevalence of syphilis was high in HIV-infected patients with transmission risk in Zhejiang. It is urgent to carry out classified management and targeted intervention in HIV-infected patients, explore multi-disease prevention and treatment mechanism, strengthen syphilis screening and treatment in HIV-infected patients to reduce the transmission of HIV and syphilis.

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