Marfatia Yogesh S, Shah Ruchi Jayeshbhai, Baxi Reema Rajesh, Surani Ashma
Department of Dermatology and Venereology, Medical College, Baroda, Gujarat, India.
Indian J Sex Transm Dis AIDS. 2018 Jan-Jun;39(1):7-12. doi: 10.4103/ijstd.IJSTD_20_18.
With the availability of free antiretroviral therapy (ART), HIV/AIDS has become a chronic manageable disease, but its transmission still continues. Early testing, though desirable, is still a far-fetched goal.
Forty-six newly detected HIV cases attending skin and sexually transmitted disease (STD) outpatient department (OPD) were studied. Careful inquiry was made to know the reason for HIV testing, marital status, concordance rate in married couples, and CD4 count at the time of presentation.
Of the 46 cases, 27 (59%) cases were in the age range of 20-40 years with 41% females and 59% males. Forty-one cases were married and cohabiting, out of which 19 were seroconcordant. Condom was used by 5/19 cases in seroconcordant group and 3/22 cases in serodiscordant group. Fourteen (30.4%) cases were tested for an epidemiologic reason (the most common being spouse positivity and antenatal care testing). Of the remaining 32 cases, the reason for testing was mucocutaneous manifestations in 16 cases, STD in 10 cases, and systemic illnesses (fever of unknown origin and weight loss) in 6 cases. Mean CD4 count was 336/cumm, with 17 cases having CD4 count <250/cumm.
Except one, all cases were tested either because they were symptomatic or were referred by health-care provider for epidemiologic reasons. The presence of mucocutaneous manifestations including STD and systemic illnesses as the reason for testing as well as low CD4 count at the time of testing suggest less and late testing. Low condom use and high STD rate in married couple imply continued intramarital transmission. Although HIV seropositivity offers an entry point into continuum of comprehensive care package which includes free ART, it appears that HIV testing is still less and late.
随着免费抗逆转录病毒疗法（ART）的普及，艾滋病毒/艾滋病已成为一种可慢性控制的疾病，但其传播仍在继续。早期检测虽然是理想的，但仍是一个遥不可及的目标。
对46例新确诊的艾滋病病例进行了研究，这些病例均前往皮肤和性传播疾病（STD）门诊就诊。仔细询问了进行艾滋病毒检测的原因、婚姻状况、已婚夫妇的一致性率以及就诊时的CD4细胞计数。
46例病例中，27例（59%）年龄在20至40岁之间，女性占41%，男性占59%。41例已婚并同居，其中19例血清学一致。血清学一致组中有5/19例使用了避孕套，血清学不一致组中有3/22例使用了避孕套。14例（30.4%）因流行病学原因进行检测（最常见的是配偶呈阳性和产前检查检测）。其余32例中，检测原因是皮肤黏膜表现的有16例，性传播疾病的有10例，全身性疾病（不明原因发热和体重减轻）的有6例。平均CD4细胞计数为336/立方毫米，17例CD4细胞计数<250/立方毫米。
除1例病例外，其他所有病例均因有症状或出于流行病学原因由医疗保健提供者转诊而进行检测。皮肤黏膜表现包括性传播疾病和全身性疾病作为检测原因以及检测时CD4细胞计数较低表明检测较少且较晚。已婚夫妇中避孕套使用率低和性传播疾病发生率高意味着婚内传播仍在继续。尽管艾滋病毒血清阳性为进入包括免费抗逆转录病毒疗法在内的综合护理套餐的连续服务提供了一个切入点，但艾滋病毒检测似乎仍然较少且较晚。
