李艳玲,何淑娴,曹艳芬,等.云南省德宏州HIV单阳家庭感染者及阳转配偶特征[J].上海预防医学,2023,35(12):1175-1180.. doi: 10.19428/j.cnki.sjpm.2023.22930
引用本文: 李艳玲,何淑娴,曹艳芬,等.云南省德宏州HIV单阳家庭感染者及阳转配偶特征[J].上海预防医学,2023,35(12):1175-1180.. doi: 10.19428/j.cnki.sjpm.2023.22930
LI Yanling,HE Shuxian,CAO Yanfen,et al.Characteristics of HIV-infected persons and their spouses who became HIV-positive in HIV discordant couples in Dehong Prefecture, Yunnan Province[J].Shanghai Journal of Preventive Medicine,2023,35(12):1175-1180.. doi: 10.19428/j.cnki.sjpm.2023.22930
Citation: LI Yanling,HE Shuxian,CAO Yanfen,et al.Characteristics of HIV-infected persons and their spouses who became HIV-positive in HIV discordant couples in Dehong Prefecture, Yunnan Province[J].Shanghai Journal of Preventive Medicine,2023,35(12):1175-1180.. doi: 10.19428/j.cnki.sjpm.2023.22930

云南省德宏州HIV单阳家庭感染者及阳转配偶特征

Characteristics of HIV-infected persons and their spouses who became HIV-positive in HIV discordant couples in Dehong Prefecture, Yunnan Province

  • 摘要:
    目的 了解云南省德宏傣族景颇族自治州(简称“德宏州”)人类免疫缺陷病毒(HIV)单阳家庭的阴性配偶发生阳转的55个家庭中先感染者和阳转配偶的基本特征、病毒载量、免疫状况以及发生HIV阳转的原因。
    方法 从中国疾病预防控制信息系统的艾滋病(AIDS)综合防治数据信息系统中筛选出2015—2021年符合标准的既往配偶检测阳性的疫情卡片,共55对夫妻。收集一般社会人口学信息、确诊年龄、接触史、CD4+T淋巴细胞计数以及抗病毒治疗等资料。采用描述性分析描述先阳配偶和阳转配偶的分布情况,并进行χ2检验。
    结果 共有55个HIV单阳家庭的阴性配偶发生HIV阳转,先阳配偶中男性占72.7%(40/55)。阳转配偶确诊时先阳配偶最近一次CD4+T淋巴细胞计数为(328.31±246.27)个·μL-1,<200个·μL-1的占36.4%(20/55)。其中,病毒载量检测低于最低检测限的占45.0%(9/20),<400拷贝·mL-1的占15.0%(3/20),≥400拷贝·mL-1的占25.0%(5/20)。16.4%(9/55)的先阳配偶未检测病毒载量。单阳家庭中阴性配偶发生HIV阳转的主要原因是安全套使用情况欠佳、先阳配偶抗病毒治疗依从性差、出现治疗脱失等情况。
    结论 应加强对德宏州HIV单阳家庭的随访管理,特别应加强先阳配偶的病毒载量水平和免疫状况监测,提高其抗病毒治疗的依从性,减少治疗脱失,从而更加有效地预防和控制HIV在夫妻间传播。

     

    Abstract:
    Objective To determine the characteristics, viral load and immunological status of HIV-infected persons and their spouses who became HIV-positive, and the reasons for HIV seroconversion in 55 HIV discordant couples in Dehong Dai and Jingpo Autonomous Prefecture (Dehong Prefecture), Yunan Province.
    Methods Data on the 55 couples meeting the criteria of having a previously positive spouse were retrieved from the AIDS Integrated Prevention and Control Data Information System of the China Disease Control and Prevention Information System during 2015-2021. General socio-demographic information, age at diagnosis, exposure history, CD4+T lymphocyte count, and antiviral treatment were collected. Descriptive analysis and chi-square test were used to compare the distribution of pre-HIV-positive spouses and their HIV seroconverted spouses.
    Results A total of 55 spouses from HIV discordant couples had HIV seroconversion. Of them, 72.7% (40/55) of pre-HIV-positive spouses were husbands. The most recent CD4+T lymphocyte count in the pre-HIV-positive spouses was (328.31± 246.27) cells·μL-1 at the time of diagnosis of their seroconverted spouses, of which 36.3% (20/55) had a CD4+T lymphocyte count of less than 200 cells·μL-1. Furthermore, of those pre-HIV-positive spouses with low CD4+T lymphocyte count, 45.0% (9/20) had an undetectable viral load, 15.0% (3/20) <400 copies·mL-1, and 25.0%(5/20) ≥400 copies·mL-1. Additionally, 16.4% (9/55) of the pre-HIV-positive spouses did not have a viral load test. The main reasons for HIV seroconversion among HIV-negative spouses in the discordant couples were poor condom use, poor compliance with antiviral therapy, and treatment discontinuation.
    Conclusion The follow-up management of HIV discordant couples should be strengthened in Dehong Prefecture, especially the monitoring of viral load levels and immunological status of pre-HIV-positive spouses, to improve their compliance with antiviral therapy and reduce treatment discontinuation, which would effectively prevent and control HIV transmission between spouses.

     

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