Ming Shuai, Wang Lu, Ge Zeng, Wang Lan, Zhou Jian-ping, He Wen-sheng
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2013 Apr;47(4):337-41.
To understand the overall HIV sero-conversion rate and its trend and risk factors of uninfected partners in sero-discordant couples.
A total of 3088 uninfected partners, whose HIV positive partners infected via former plasma donation or blood transfusion from July, 2006 to December 2010, were chosen as a fix cohort. They were tested for HIV antibodies twice a year using ELISA by local CDC from July, 2006 to December, 2010. Data regarding demographic, sexual behavior information of uninfected partners and infection, serologic characteristics of positive partners were retrospectively surveyed and collected to analyze possible risky factors.
A total of 132 in 3088 uninfected partners were sero-converted, with a sero-conversion rate of 1.17/100 person years (95%CI: 0.99/100 person years -1.39/100 person years). Sero-conversion rate reached the peak (0.82%) in the following interval of January and June in 2008 and have a bottom conversion rate (0.13%) in the same month interval in 2010. Conversion rate outcome showed a downward trend in following(χ(2)trend = 8.907, P < 0.05). In the survey, 56.6% (1513/2673) uninfected partners were males, 56.2% (1501/2673) were with lower education level. Among uninfected partners, as reported by themselves, having sex in recently 6 months accounted for a proportion of 81.4% (2176/2673), sex frequency of less than 4 times per month accounted for 45.7% (1169/2558) and consistent using of condom accounted for 94.5% (2418/2558). The proportion of the index partners' most recently CD4 cell count less than 200 cells per µl was 17.4% (437/2505). Results from multivariate of Cox regression showed that male negative partners (RR = 1.58, 95%CI: 1.02 - 2.43), negative partners with lower education level(RR = 2.77, 95%CI: 1.68 - 4.57), having sexual activity in latest one year(RR = 4.39, 95%CI: 1.53 - 12.56) and CD4 count less than 200 cells per µl (RR = 2.36, 95%CI: 1.42 - 3.93) were associated with increased risk of HIV sero-conversion, while intercourse frequency less than 4 times per month(RR = 0.18, 95%CI: 0.10 - 0.32), consistent using of condom(RR = 0.07, 95%CI: 0.05 - 0.12) decreased the risk of conversion.
In this city, the conversion rate of negative partners whose positive partner infected via former plasma donation or blood transfusion is relatively low and behave a downward trend. Serologic surveillance, education and intervention based on couple are needed to be enhanced.
了解血清学不一致夫妻中未感染伴侣的总体HIV血清转化发生率及其趋势和危险因素。
选取2006年7月至2010年12月期间其HIV阳性伴侣因既往有偿供血或输血感染的3088名未感染伴侣作为固定队列。2006年7月至2010年12月,由当地疾控中心每年用ELISA法对他们进行两次HIV抗体检测。回顾性调查并收集未感染伴侣的人口统计学、性行为信息以及感染情况、阳性伴侣的血清学特征,以分析可能的危险因素。
3088名未感染伴侣中共有132人发生血清转化,血清转化率为1.17/100人年(95%可信区间:0.99/100人年 - 1.39/100人年)。血清转化率在2008年1月至6月期间达到峰值(0.82%),在2010年同月期间转化率最低(0.13%)。转化率结果呈下降趋势(χ(2)趋势 = 8.907,P < 0.05)。调查中,56.6%(1513/2673)的未感染伴侣为男性,56.2%(1501/2673)教育程度较低。在未感染伴侣中,据其自述,近6个月有性行为的占81.4%(2176/2673),每月性行为次数少于4次的占45.7%(1169/2558),坚持使用避孕套的占94.5%(2418/2558)。索引伴侣最近CD4细胞计数低于200个/微升的比例为17.4%(437/2505)。Cox多因素回归结果显示,男性阴性伴侣(RR = 1.58,95%可信区间:1.02 - 2.43)、教育程度较低的阴性伴侣(RR = 2.77,95%可信区间:1.68 - 4.57)、近一年有性行为(RR = 4.39,95%可信区间:1.53 - 12.56)以及CD4计数低于200个/微升(RR = 2.36,95%可信区间:1.42 - 3.93)与HIV血清转化风险增加相关,而每月性行为次数少于4次(RR = 0.18,95%可信区间:0.10 - 0.32)、坚持使用避孕套(RR = 0.07,95%可信区间:0.05 - 0.12)可降低转化风险。
在本市,其阳性伴侣因既往有偿供血或输血感染的阴性伴侣转化率相对较低且呈下降趋势。需加强基于夫妻的血清学监测、教育和干预。