Fu Zhuo-hua, Gao Mei-yang, Chen Li, Kang Yong-ran, Yang Jian-hua, He Na
Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2009 Nov;30(11):1139-42.
To explore the sero-prevalence and risk factors for herpes simplex virus 2 (HSV-2) infection and unprotected sexual behavior in an ethnically diverse population of HIV-infected subjects in a county of Yunnan province.
HIV-infected individuals attending for routine follow-up by local Center for Disease Control and Prevention (CDC) were recruited to participate in the study under 'informed consent'. A face-to-face questionnaire interview was administered to each participant. Blood was drawn for HSV-2 testing by HerpeSelect HSV-2 ELISA (Focus Diagnostics) and CD(4)(+) T counting.
A total of 300 HIV-infected individuals participated in the study. The mean age of the subjects was 37.6 years with 76.7% as males. Ethnically, Han, Dai and Jingpo accounted for 44.3%, 37.3% and 16.0% of the sample, respectively. Half of the subjects reported HIV acquisition through injection drug use. The sero-prevalence of HSV-2 was 35.0%. Results from multiple logistic regression analysis indicated that individuals who acquired HIV through heterosexual contact were more likely to be HSV-2 positive than those who acquired HIV through injection drug use (OR = 4.244, 95%CI: 1.924 - 9.364), whereas Dai (OR = 0.300, 95%CI: 0.152 - 0.593) and Jingpo (OR = 0.376, 95%CI: 0.167 - 0.850) were less likely to be HSV-2 positive than the Hans. Among 105 people who were co-infected with HIV/HSV-2, 60 had sexual intercourses in the past 3 months and 41.7% of them reported no or inconsistent use of condoms. Most unprotected sexual contacts occurred within married couples.
HSV-2 infection was highly prevalent among HIV-infected individuals in this county, and a significant proportion of HIV/HSV-2 co-infected subjects engaged in unprotected sex. HSV-2 testing, behavioral and biomedical interventions among HIV-infected individuals and their sexual partners should be involved in the local HIV prevention and control programs.
探讨云南省某县不同民族的HIV感染人群中单纯疱疹病毒2型（HSV-2）感染及无保护性行为的血清流行率和危险因素。
招募到当地疾病预防控制中心（CDC）进行常规随访的HIV感染者，在“知情同意”的情况下参与本研究。对每位参与者进行面对面问卷调查。采集血液，采用HerpeSelect HSV-2 ELISA（Focus Diagnostics）检测HSV-2，并进行CD4+T细胞计数。
共有300名HIV感染者参与本研究。受试者的平均年龄为37.6岁，男性占76.7%。从民族来看，汉族、傣族和景颇族分别占样本的44.3%、37.3%和16.0%。一半的受试者报告通过注射吸毒感染HIV。HSV-2的血清流行率为35.0%。多因素logistic回归分析结果表明，通过异性接触感染HIV的个体比通过注射吸毒感染HIV的个体更易感染HSV-2（OR = 4.244，95%CI：1.924 - 9.364），而傣族（OR = 0.300，95%CI：0.152 - 0.593）和景颇族（OR = 0.376，95%CI：0.167 - 0.850）感染HSV-2的可能性低于汉族。在105例HIV/HSV-2合并感染的患者中，60例在过去3个月内有性行为，其中41.7%的患者报告未使用避孕套或使用避孕套不规范。大多数无保护性行为发生在已婚夫妇之间。
该县HIV感染者中HSV-2感染非常普遍，相当一部分HIV/HSV-2合并感染的受试者有未保护的性行为。当地的HIV预防控制项目应包括对HIV感染者及其性伴侣进行HSV-2检测、行为和生物医学干预。
