中国在 SARS 后时代通过全国性监测系统确定的 HIV 和艾滋病的流行模式变化。
Changing epidemiological patterns of HIV and AIDS in China in the post-SARS era identified by the nationwide surveillance system.
机构信息
State Key Laboratory of Genetic Engineering and Collaborative Innovation Center for Genetics and Development, School of Life Sciences, Fudan University, Shanghai, 200032, China.
Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.
出版信息
BMC Infect Dis. 2018 Dec 27;18(1):700. doi: 10.1186/s12879-018-3551-5.
BACKGROUND
China has made substantial progress in tackling its HIV and AIDS epidemic. But the changing patterns of HIV and AIDS incidence based on the longitudinal observation data were rarely studied.
METHODS
The reporting incidence (RI) and mortality data on HIV and AIDS in China covering 31 provinces from 2004 to 2014 were collected from the Chinese Public Health Science Data Center. To decompose the time-series data, Empirical Mode Decomposition (EMD) was applied to properly describe the trends of HIV and AIDS incidence. A mathematical model was used to estimate the relative change of incidence among provinces and age groups.
RESULTS
A total of 483,010 newly HIV infections and 214,205 AIDS cases were reported between 2004 and 2014 nationwide. HIV infection increased from 13,258 in 2004 (RI 1.02 per 100,000 person years) to 74,048 in 2014 (RI 5.46 per 100,000). The number of AIDS cases increased from 3054 in 2004 (RI 0.23 per 100,000) to 45,145 in 2014 (RI 3.33 per 100,000). The overall relative changes for HIV infection and AIDS incidence were 1.11 (95% confidence interval [CI] 1.10-1.13) and 1.28 (95% CI 1.23-1.33), respectively. The relative increase for HIV and AIDS RI was higher in northwest provinces while lower in Henan, Xinjiang, Guangxi and Yunnan. The overall relative changes for HIV infection were 1.12 (95% CI 1.11-1.14) in males and 1.10 (95% CI 1.06-1.13) in females. For AIDS RI, the relative increases were 1.31 (95% CI 1.26-1.36) in males and 1.22 (95% CI 1.17-1.28) in females. The lowest relative increase was detected among young adults, while the largest relative increase (odds ratio [OR] > 1.30) was detected in people aged 55 years or above.
CONCLUSIONS
HIV and AIDS showed an increasing trend in China from 2004 to 2014, respectively, but the epidemic tended to be under control among provinces and young people that used to have a high HIV and AIDS incidence. Northwest China and older people could be new "hop-spots" for HIV and AIDS risk.
背景
中国在应对艾滋病疫情方面取得了重大进展。但基于纵向观察数据，HIV 和艾滋病发病率变化模式的研究却很少。
方法
本研究收集了 2004 年至 2014 年中国 31 个省的 HIV 和艾滋病报告发病率（RI）和死亡率数据。为了解 HIV 和艾滋病发病率的趋势，本研究采用经验模态分解（EMD）对时间序列数据进行分解。采用数学模型估计各省和各年龄组发病率的相对变化。
结果
2004 年至 2014 年期间，全国共报告 483010 例新 HIV 感染和 214205 例艾滋病病例。HIV 感染从 2004 年的 13258 例（RI 为每 10 万人 1.02 例）增加到 2014 年的 74048 例（RI 为每 10 万人 5.46 例）。艾滋病病例从 2004 年的 3054 例（RI 为每 10 万人 0.23 例）增加到 2014 年的 45145 例（RI 为每 10 万人 3.33 例）。HIV 感染和艾滋病发病率的总体相对变化分别为 1.11（95%置信区间 [CI] 1.10-1.13）和 1.28（95% CI 1.23-1.33）。HIV 和艾滋病 RI 的相对增长率在西北地区较高，而在河南、新疆、广西和云南较低。HIV 感染的总体相对变化在男性为 1.12（95% CI 1.11-1.14），在女性为 1.10（95% CI 1.06-1.13）。对于 AIDS RI，男性的相对增长率为 1.31（95% CI 1.26-1.36），女性为 1.22（95% CI 1.17-1.28）。年轻人的相对增长率最低，而年龄在 55 岁及以上的人的相对增长率最大（比值比 [OR] > 1.30）。
结论
2004 年至 2014 年期间，中国 HIV 和艾滋病呈上升趋势，但在 HIV 和艾滋病发病率较高的省份和年轻人中，疫情趋于得到控制。中国西北部和老年人可能成为 HIV 和艾滋病风险的新“热点”。
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