Kumarasamy N, Venkatesh K K, Srikrishnan A K, Prasad L, Balakrishnan P, Murugavel K G, Thamburaj E, Solomon S, Mayer K H
YRG Centre for AIDS Research and Education, Chennai, India.
Int J STD AIDS. 2010 Feb;21(2):96-100. doi: 10.1258/ijsa.2008.008418.
The aim of the article is to compare the clinical and behavioural characteristics of HIV-infected South Indian patients in concordant and discordant heterosexual relationships. A cross-sectional analysis of married couples in concordant and discordant relationships was carried out. Demographic and clinical characteristics, sexual behaviours, CD4 cell count and plasma HIV-1 RNA loads were assessed. A total of 839 concordant patients and 996 discordant patients were included in this analysis. Significantly more men were in discordant than concordant relationships (97% versus 59%; P = 0.002). More discordant patients had never initiated highly active antiretroviral treatment (HAART) than concordant patients (14.1% versus 8.5%; P = 0.004). Concordant patients had significantly higher CD4 cell counts than discordant patients at the time of enrolling to care (205 versus 139 cells/microL; P = 0.001). Discordant patients had significantly higher plasma viral loads than concordant patients (100,000 copies/mL versus 89,154 copies/mL; P = 0.002). Discordant patients were more likely to use condoms with their spouses than concordant patients (49% versus 28.8%; P = 0.01). In conclusion, couples-based interventions and the provision of HAART could substantially decrease behavioural and clinical correlates of HIV transmission among discordant South Indian married couples. The spouses of HIV-infected index patients are at increased risk for HIV infection, and further preventive measures are needed.
本文旨在比较印度南部感染艾滋病毒的异性恋伴侣关系中，伴侣双方感染情况一致和不一致的患者的临床及行为特征。对伴侣关系一致和不一致的已婚夫妇进行了横断面分析。评估了人口统计学和临床特征、性行为、CD4细胞计数及血浆HIV-1 RNA载量。本分析共纳入839名伴侣关系一致的患者和996名伴侣关系不一致的患者。伴侣关系不一致的男性比例显著高于伴侣关系一致的男性（97%对59%；P = 0.002）。从未开始高效抗逆转录病毒治疗（HAART）的伴侣关系不一致的患者多于伴侣关系一致的患者（14.1%对8.5%；P = 0.004）。在纳入治疗时，伴侣关系一致的患者CD4细胞计数显著高于伴侣关系不一致的患者（205个/微升对139个/微升；P = 0.001）。伴侣关系不一致的患者血浆病毒载量显著高于伴侣关系一致的患者（100,000拷贝/毫升对89,154拷贝/毫升；P = 0.002）。伴侣关系不一致的患者比伴侣关系一致的患者更有可能与配偶使用避孕套（49%对28.8%；P = 0.01）。总之，基于伴侣的干预措施和提供HAART可大幅降低印度南部伴侣关系不一致的已婚夫妇中与艾滋病毒传播相关的行为和临床因素。艾滋病毒感染指数患者的配偶感染艾滋病毒的风险增加，需要进一步采取预防措施。
