Gertig D, Crofts N, Stevenson E, Breschkin A
Macfarlane Burnet Centre for Medical Research, Fairfield, VIC.
Med J Aust. 1993 Jan 4;158(1):17-20.
To describe the epidemiology of infection with the human immunodeficiency virus type 1 (HIV-1) in Victoria from 1980 to 1991.
Data on HIV-1 infection in Victoria, obtained through routine laboratory-based surveillance, were entered in a database. Missing information was sought by contacting the referring doctor where possible.
In Victoria, the acquired immunodeficiency syndrome (AIDS) is notifiable to Health Department Victoria by diagnosing doctors, and laboratories are required to notify new diagnoses of HIV-1 infection, without identifiers. All confirmatory testing for HIV-1 has taken place at the State HIV Reference Laboratory at Fairfield Hospital.
Diagnoses of HIV-1 infection, as confirmed at the State HIV Reference Laboratory by western blot immunoassay, and notifications of AIDS to Health Department Victoria.
Over six years the annual number of diagnoses of HIV-1 infection in Victoria remained constant despite a substantial increase in the number of tests performed. To the end of 1991, 2679 people had been diagnosed with HIV-1 infection, 686 of whom had developed AIDS. Information on exposure was available for 2379 (88.8%). Homosexual and bisexual men made up 75.5% (85.0% of those for whom exposure had been ascertained); 3.4% were female or heterosexual male injecting drug users; and 3.7% were heterosexuals with no history of injecting drug use. The latter two groups contributed 2.0% in 1985 to the proportion of all new diagnoses for which exposure was known, and 14.3% in 1991; for recipients of contaminated blood or blood products before 1985 this proportion fell from 12.4% to 1.0%. The cumulative incidence of HIV-1 diagnoses was highest in the age group 25-29 years, and 20% of all HIV-1 infected people were under 25 at the time of diagnosis. In 1991, 81 of the 311 people who had been diagnosed with HIV-1 infection had had previous negative or indeterminate results of tests; half of these had acquired infection in the previous year.
Most HIV-1 infections in Victoria have been acquired through male homosexual contact, with a small but increasing proportion of diagnoses occurring in heterosexuals. Laboratory-based surveillance of voluntary testing, despite its limitations, has provided valuable information on the extent of the HIV-1 epidemic in Victoria. Surveillance of all HIV-1 test results and of seroconverters now supplements routine surveillance of HIV diagnoses and will ensure a more accurate picture of the epidemic in coming years.
描述1980年至1991年维多利亚州人类免疫缺陷病毒1型（HIV-1）感染的流行病学情况。
通过基于实验室的常规监测获得的维多利亚州HIV-1感染数据被录入数据库。如有可能，通过联系转诊医生来查找缺失信息。
在维多利亚州，诊断医生需向维多利亚州卫生部报告获得性免疫缺陷综合征（AIDS），实验室需报告HIV-1感染的新诊断病例，且不提供标识符。所有HIV-1的确诊检测均在费尔菲尔德医院的州HIV参考实验室进行。
经蛋白质印迹免疫分析在州HIV参考实验室确诊的HIV-1感染诊断病例，以及向维多利亚州卫生部报告的AIDS病例。
在六年时间里，尽管检测数量大幅增加，但维多利亚州HIV-1感染的年度诊断病例数保持稳定。到1991年底，已有2679人被诊断为HIV-1感染，其中686人已发展为AIDS。有2379人（88.8%）的暴露信息可用。同性恋和双性恋男性占75.5%（在已确定暴露情况的人中占85.0%）；3.4%为女性或异性恋男性注射吸毒者；3.7%为无注射吸毒史的异性恋者。后两组在1985年占已知暴露情况的所有新诊断病例比例的2.0%，在1991年占14.3%；1985年前接受受污染血液或血液制品的人群这一比例从12.4%降至1.0%。HIV-1诊断的累积发病率在25 - 29岁年龄组最高，所有HIV-1感染者中20%在诊断时年龄小于25岁。1991年，在311名被诊断为HIV-1感染的人中，有81人之前的检测结果为阴性或不确定；其中一半在去年感染。
维多利亚州的大多数HIV-1感染是通过男性同性恋接触获得的，异性恋者中的诊断病例比例虽小但在增加。基于实验室的自愿检测监测尽管有其局限性，但已提供了有关维多利亚州HIV-1流行程度的有价值信息。对所有HIV-1检测结果和血清转化者的监测现在补充了HIV诊断的常规监测，并将确保在未来几年更准确地了解疫情。
