Zhang Fu-jie, Dou Zhi-hui, Yu Lan, Ma Ye, Wang Ning, Cao Guang-hua, Li Chuan-tao, Zhao Jin-xian, Meng Xiang-dong, Qiao Xiao-chun, Huo Wei, Zhao Hong-xin, Liu Zhong-fu, Wang Lie, Shang Hong
National center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2008 Jan;29(1):9-12.
Discussing the natural history and the influencing factors of HIV infection among former commercial blood and plasma donors engaged in unsafe blood donation practices in China.
Using ambispective cohort study, with data obtained from ten counties (districts) from six provinces in the National AIDS Control Demonstration Area. HIV/AIDS cases were found and confirmed prior to July 24, 2006 being former commercial blood. Plasma donors were selected and data regarding infection, incidence, death, and influencing factors was collected. Analysis was performed using SPSS 12.0 statistical analysis software.
(1) In 7551 cases of HIV infection, there were 6533 typical progressors (86.52%, 4757 cases of AIDS), 108 rapid progressors (1.43%), 910 long-term non-progressors (12.05%) with 4865 cases progressed to AIDS (64.43%). The median incubation period for HIV progression to AIDS was nine years (95% CI:8.96-9.04). (2) According to data, from a total of 1157 AIDS cases without ARV therapy (23.78% of total AIDS cases), there were 283 confirmed AIDS-related deaths, of which the median survival time was 6 months (95% CI:4-7) and the two and three year fatality rates were 95% and 99%, respectively. (3) The duration of HIV incubation period was irrespective to gender and age at the time of HIV infection (P > 0.05). Length of survival for untreated AIDS showed correlation to gender (P < 0.05) but no correlation with culture, marital status or age at the time of diagnosis of AIDS (P > 0.05).
Compared with the UNAIDS theory regarding slow disease progressors among adults, our study showed a longer AIDS incubation period and shorter outlook for untreated survival, but a similar incubation period for other routes of HIV infection.
探讨中国既往从事不安全献血行为的商业献血浆者中艾滋病病毒(HIV)感染的自然史及影响因素。
采用双向队列研究,数据来自国家艾滋病防治示范区6个省的10个县(区)。选取2006年7月24日前确诊的HIV/AIDS病例且曾为商业献血浆者,收集感染、发病、死亡及影响因素等数据。使用SPSS 12.0统计分析软件进行分析。
(1)在7551例HIV感染者中,典型进展者6533例(86.52%,其中4757例发展为艾滋病),快速进展者108例(1.43%),长期不进展者910例(12.05%),4865例进展为艾滋病(64.43%)。HIV进展为艾滋病的中位潜伏期为9年(95%可信区间:8.96 - 9.04)。(2)数据显示,在1157例未接受抗逆转录病毒治疗的艾滋病病例中(占艾滋病病例总数的23.78%),确诊艾滋病相关死亡283例,其中位生存时间为6个月(95%可信区间:4 - 7),2年和3年病死率分别为95%和99%。(3)HIV潜伏期与感染时的性别和年龄无关(P>0.05)。未治疗艾滋病患者的生存时间与性别相关(P<0.05),但与诊断艾滋病时的文化程度、婚姻状况或年龄无关(P>0.05)。
与联合国艾滋病规划署关于成人中疾病进展缓慢者的理论相比,本研究显示艾滋病潜伏期更长,未治疗生存预后更短,但与其他HIV感染途径的潜伏期相似。