Li Jianjun, Zhang Hongman, Shen Zhiyong, Zhou Yuejiao, Fang Ningye, Wang Lu, Wang Bin, Wang Jiangwei, Tang Zhenzhu
Guangxi Central Laboratory of HIV/AIDS Confirmation, Institute of HIV/AIDS Prevention and Control, Guangxi Center for Disease Control and Prevention, Nanning, China.
Institute of HIV/AIDS Prevention and Control, Guangxi Center for Disease Control and Prevention, Nanning, China.
PLoS One. 2014 Jun 11;9(6):e99522. doi: 10.1371/journal.pone.0099522. eCollection 2014.
Guangxi has become one of the provinces with the most severe HIV-1 epidemic in China, where heterosexual contact is the dominant transmission route. However, data of acute HIV infections and HIV incidence among female sex workers (FSWs) from low-grade venues are scant.
A cross-sectional survey was performed among FSWs from low-grade venues in Guangxi. HIV antibody screening was performed by rapid testing (RT). HIV antibody-negative specimens were screened by pooled nucleic acid amplification testing (NAAT) for acute HIV infections. HIV antibody-positive specimens were further analyzed by Western blot (WB), followed by an HIV-1 BED capture enzyme immunoassay (BED-CEIA) to identify the recent infections. HIV-1 incidence was estimated by the data of pooled NAAT and BED-CEIA, respectively.
A total of 7936 FSWs were recruited and answered the questionnaires. We successfully collected the blood samples from 6469 (81.5%) participants, of which 139 (2.1%) were HIV antibody-positive and 6330 (97.9%) were HIV antibody-negative by RT. With pooled NAAT, 7 cases were found to be HIV RNA positive, representing an additional 5.0% of HIV-infected persons and an estimated HIV incidence of 1.45 (95% CI: 1.17-1.76) per 100 person years. There were 137 positive and 2 indeterminate by WB, of which 124 (90.5%) positive specimens were subjected to BED-CEIA testing identifying 28 recent infections. The HIV incidence determined by BED-CEIA testing was 1.04 (95% CI: 0.65-1.43) per 100 person years. The overall prevalence of HIV among FSWs from low-grade venues in Guangxi was 2.2% (95% CI: 1.9-2.6).
We found that the addition of HIV RNA screening to routine HIV antibody testing significantly improved the detection of HIV infection among FSWs from low-grade venues in Guangxi. Our findings also provided the useful baseline data of HIV incidence among this population for targeting local HIV prevention, intervention, monitoring and treatment.
广西已成为中国艾滋病病毒1型（HIV-1）疫情最严重的省份之一，异性传播是主要传播途径。然而，来自低档次场所的女性性工作者（FSW）中急性HIV感染和HIV发病率的数据却很匮乏。
对广西低档次场所的FSW进行了一项横断面调查。通过快速检测（RT）进行HIV抗体筛查。对HIV抗体阴性样本采用混合核酸扩增检测（NAAT）筛查急性HIV感染。对HIV抗体阳性样本进一步采用免疫印迹法（WB）分析，随后进行HIV-1 BED捕获酶免疫测定（BED-CEIA）以确定近期感染情况。分别根据混合NAAT和BED-CEIA的数据估算HIV-1发病率。
共招募了7936名FSW并完成问卷调查。成功采集了6469名（81.5%）参与者的血样，其中RT检测显示139名（2.1%）为HIV抗体阳性，6330名（97.9%）为HIV抗体阴性。通过混合NAAT，发现7例HIV RNA阳性，这意味着额外5.0%的HIV感染者，估计HIV发病率为每100人年1.45（95%置信区间：1.17 - 1.76）。WB检测有137例阳性和2例不确定，其中124例（90.5%）阳性样本进行了BED-CEIA检测，确定有28例近期感染。通过BED-CEIA检测确定的HIV发病率为每100人年1.04（95%置信区间：0.65 - 1.43）。广西低档次场所FSW中HIV的总体患病率为2.2%（95%置信区间：1.9 - 2.6）。
我们发现，在常规HIV抗体检测中增加HIV RNA筛查可显著提高广西低档次场所FSW中HIV感染的检测率。我们的研究结果还为该人群的HIV发病率提供了有用的基线数据，有助于针对当地的HIV预防、干预、监测和治疗。
