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韩国新诊断为 HIV 阳性者中近期 HIV 感染特征(2008-2015 年)。

Characteristics of recent HIV infection among individuals newly diagnosed as HIV-positive in South Korea (2008-2015).

机构信息

Division of Clinical Research, Center for Emerging Virus Research, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Chungbuk, Republic of Korea.

Division of Public Health Emergency Response Research, Director General for Public Health Emergency Preparedness, Korea Disease Control and Prevention Agency, Chungbuk, Republic of Korea.

出版信息

Sci Rep. 2022 Jun 22;12(1):10515. doi: 10.1038/s41598-022-13953-0.

Abstract

Most HIV-positive individuals diagnosed in Korea are infected through sexual contact, with the time of HIV infection therefore often being unknown. The aim of this study was to investigate the characteristics of diagnosed patients near the time of HIV seroconversion to establish useful HIV intervention strategies. Cross-sectional study. Newly diagnosed HIV cases based on the national HIV surveillance system in South Korea, 2008-2015. To distinguish recent from long-standing HIV infection among 5898 nationwide HIV-positive specimens, limiting antigen avidity assays (Sedia HIV-1 LAg-Avidity EIA, cut-off = 1.5) were performed. Data on CD4+ T cell count at HIV diagnosis and death from AIDS within one year after first HIV diagnosis were used to distinguish recent HIV infections. Acute HIV infection is characterized by detectable HIV RNA or HIV p24 antigen levels, along with a negative or indeterminate antibody western blot result, but with the subject subsequently testing positive after a predetermined period. We analyzed the characteristics of recent and acute HIV infections by sex, age, nationality, HIV testing site, region, and reason for HIV testing. Recent and acute HIV infections were described as the proportion of recent and acute HIV infections among newly-diagnosed cases in a given year. Recent and acute HIV infections over the 8-year study period were 20.5% (1210/5898) and 9.5% (562/5898), respectively. Both infections were generally higher in the following groups: males, younger age, Koreans, individuals who were tested due to disease, residents of smaller city or rural area, and individuals diagnosed in recent calendar years. Acute infections were significantly higher among individuals tested in hospitals and due to suspected HIV infection. The recent and acute HIV infection in younger age groups (< 30 years) has been increasing in a given year. There was an increase in the proportion of young individuals with recent HIV infection, and we identified risk groups more at risk of HIV infection recently in Korea. Therefore, our results could prove useful for the development and assessment of national HIV prevention strategies in Korea and provide valuable data for further HIV research.

摘要

大多数在韩国诊断出的 HIV 阳性个体是通过性接触感染的,因此 HIV 感染的时间往往未知。本研究旨在调查接近 HIV 血清转换时诊断出的患者的特征,以制定有用的 HIV 干预策略。横断面研究。2008-2015 年,基于韩国国家 HIV 监测系统的新诊断 HIV 病例。为了区分全国 5898 例 HIV 阳性标本中近期和长期 HIV 感染,进行了限制抗原亲和力检测(Sedia HIV-1 LAg-Avidity EIA,临界值=1.5)。使用 HIV 诊断时的 CD4+T 细胞计数和首次 HIV 诊断后一年内因 AIDS 死亡的数据来区分近期 HIV 感染。急性 HIV 感染的特征是可检测到 HIV RNA 或 HIV p24 抗原水平,同时抗体 Western blot 结果为阴性或不确定,但随后在预定时间后检测为阳性。我们按性别、年龄、国籍、HIV 检测地点、地区和 HIV 检测原因分析近期和急性 HIV 感染的特征。在给定年份的新诊断病例中,描述了近期和急性 HIV 感染的比例。在 8 年的研究期间,近期和急性 HIV 感染分别为 20.5%(1210/5898)和 9.5%(562/5898)。这两种感染在以下人群中通常更高:男性、年轻、韩国人、因疾病而接受检测的人、小城市或农村地区的居民、以及最近几年被诊断出的人。在医院接受检测和因疑似 HIV 感染而接受检测的个体中,急性感染明显更高。年轻年龄组(<30 岁)的近期和急性 HIV 感染在给定年份呈上升趋势。年轻的近期 HIV 感染者比例有所增加,我们确定了韩国最近感染 HIV 风险较高的人群。因此,我们的结果可能对韩国国家 HIV 预防策略的制定和评估有用,并为进一步的 HIV 研究提供有价值的数据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65bf/9217788/39bbc17364f3/41598_2022_13953_Fig1_HTML.jpg

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