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目的在河南省某地农村建立艾滋病病毒(HI V)感染状况不一致(DC)的夫妻队列并进行随访,观察HI V通过异性性传播的频率及其影响因素。方法通过访谈和血清学检测,确定了52对(一方HI V阳性而另一方阴性但无吸毒、性乱、输血等HI V感染危险行为)夫妻进入研究队列,在0.5、1和2.5年进行3次随访,每次随访均询问夫妻双方的性生活和安全套使用情况,同时抽取20ml抗凝静脉血检测HI V抗体、CD4+T淋巴细胞计数以及病毒载量。结果(1)0.5、1和2.5年的随访率分别是92.3%、75.0%和28.8%。在随访的过程中,DC夫妻中HI V阴性一方HI V抗体始终保持阴性,未出现HI V抗体阳转及HI V的传播。(2)在队列建立时(0年)以及0.5、1和2.5年随访时,DC夫妻性生活次数每月1次至每周1次的分别占65.4%、72.9%、71.7%和80.0%,有时使用或从来不用安全套的比例分别是76.9%、66.6%、69.1%和60.0%,不同随访时间性生活次数和安全套使用频率的差异无统计学意义。(3)DC夫妻中的HI V阳性一方在0.5、1和2.5年随访时,CD4+T淋巴细胞计数保持稳定或上升的比例分别是85.4%、66.6%和60.0%。15对在2.5年随访到双方的夫妻,HI V阳性一方中病毒载量稳定和下降的占66.7%,绝大部分病毒载量保持稳定或下降者同时CD4+T淋巴细胞计数也保持稳定或上升。结论研究中未观察到HI V在夫妻之间的传播。HI V阳性一方稳定的病毒载量和CD4+T细胞计数可能是HI V未发生传播的原因之一,宿主的遗传免疫学因素以及HI V的生物学特性对传播的影响值得深入研究。
Objective To establish a cohort of couples with inconsistent (HIV) HIV status in a rural area of Henan Province and follow-up to observe the frequency and influencing factors of HI V transmission through heterosexuality. Methods Through interviews and serological tests, 52 couples (one HI V positive but the other negative but no drug abuse, sexual chaos, blood transfusions and other HI V infection risk behaviors) were included in the study cohort and were enrolled in the study cohort at 0.5, 1 and 2.5 years Follow-up visits were conducted to inquire about the sexual life and condom use of both spouses at each follow-up. At the same time, 20 ml of anticoagulated venous blood was collected to detect HI V antibody, CD4 + T lymphocyte count and viral load. Results (1) The follow-up rates of 0.5, 1 and 2.5 years were 92.3%, 75.0% and 28.8% respectively. During the follow-up period, the negative HI V antibodies of negative DC V negatives in DC couples remained negative all the time, and the HI V antibody positive and HI V transmission did not occur. (2) When the cohort was established (0 years) and at 0.5, 1 and 2.5 years follow-up, the frequency of sexual intercourse among DC couples was 65.4%, 72.9%, 71.7% and 80.0% The rates of condom use with or without condom use were 76.9%, 66.6%, 69.1% and 60.0%, respectively. There was no significant difference in the frequency of condom use and the number of condom use at different follow-up visits. (3) The proportions of CD4 + T lymphocyte count remained stable or increased at 85.1%, 66.6% and 60.0%, respectively, at the HI V positive parties of DC couples at 0.5, 1 and 2.5 years of follow-up. 15 For couples who followed up for 2.5 years in both groups, the viral load in the HI V positive group was stable and decreased by 66.7%, with most of the viral load remaining stable or declining, while the CD4 + T lymphocyte count remained stable or rising . Conclusion No transmission of HI V between couples was observed in the study. The stable viral load and the CD4 + T cell count of HI V-positive patients may be one of the reasons that HI V is not transmitted. The genetic and immunological factors of HI V and the biological characteristics of HI V deserve further study.