Lu'an Center for Disease Control and Prevention,Lu'an,China.
School of Basic Medical Science, Anhui Medical University,Hefei,China.
Epidemiol Infect. 2019 Jan;147:e205. doi: 10.1017/S095026881900089X.
This study aims to investigate the human immunodeficiency virus (HIV) transmission rate in HIV serodiscordant couples, in addition to the relevant influencing factors. From January 1999 to August 2016, patients with HIV/AIDS (index cases) along with their fixed partners were registered and monitored to determine the rate of HIV transmission between couples, as well as relevant influencing factors. A total of 231 HIV-positive couples were investigated, of these, 45-negative (19.48%) partners were infected with HIV via sexual transmission prior to diagnosis of the first case detected in couples. After diagnosis, the transmission rate between spouses was 0.39 per 100 person-years (2/507.7), and the cumulative transmission rate was 1.08% (2/186), which was significantly lower than the transmission rate before diagnosis (χ2 = 35.714, P < 0.001). Among the 119 HIV/AIDS patients who received antiretroviral therapy (ART), the transmission rate was 0 (0/119), whereas the transmission rate was 2.99% (2/67) in HIV/AIDS patients who did not receive ART. In addition, HIV transmission rate in serodiscordant couples was high prior to diagnosis of the index case. However, following diagnosis, the transmission rate was reduced, and the risk of transmission in the index case with antiviral treatment was null. Therefore, a prompt intervention in HIV discordant couples with ART of index case is vital to reduce the risk of HIV transmission.
本研究旨在调查 HIV 血清学不一致夫妇中的人类免疫缺陷病毒（HIV）传播率，并探讨相关影响因素。研究对象为 1999 年 1 月至 2016 年 8 月期间登记并监测的 HIV 感染者/AIDS 患者及其固定性伴，以确定夫妇间 HIV 的传播率及其相关影响因素。共调查了 231 对 HIV 阳性夫妇，其中 45 对（19.48%）固定性伴在夫妇中首例确诊前通过性传播感染 HIV。确诊后，配偶间的传播率为 0.39/100 人年（2/507.7），累计传播率为 1.08%（2/186），明显低于确诊前的传播率（χ2=35.714，P < 0.001）。在接受抗反转录病毒治疗（ART）的 119 例 HIV/AIDS 患者中，无一例发生传播（0/119），而未接受 ART 的 67 例 HIV/AIDS 患者中传播率为 2.99%（2/67）。此外，在确诊首例患者前，血清学不一致夫妇的 HIV 传播率较高。但确诊后，传播率降低，且接受抗病毒治疗的首例患者发生传播的风险为零。因此，及时对 HIV 血清学不一致的夫妇进行 ART 干预，对于降低 HIV 传播风险至关重要。
