德宏傣族景颇族自治州新报告85对HIV双阳夫妻感染途径和传播关系分析

Transmission route and relationship among newly reported HIV concordant couples in Dehong Prefecture of Yunnan Province from 2015 to 2019

目的分析德宏傣族景颇族自治州(简称德宏州)2015-2019年新报告的85对HIV双阳夫妻感染途径和传播关系。方法收集HIV双阳夫妻的一般人口学特征信息、流行病学个案调查资料等,描述双阳夫妻特征;结合pol基因序列检测分析,判断夫妻间传播关系。结果纳入分析的85对HIV双阳夫妻共170人中,97.1%为异性性行为感染,主要HIV亚型有C型(33.5%)、BC重组型(18.2%)、CRF01_AE(14.1%)。判断27对双阳夫妻(31.8%)存在夫妻间传播关系,其中家庭内先证感染者男性17人,女性10人,夫妻对间基因亚型均一致,以C型(12对)和BC重组型(6对)为主,先证者高危行为史以非商业非婚异性性接触史为主。结论德宏州HIV双阳夫妻感染途径主要为异性性传播,且存在一定比例的夫妻间传播关系,提示有必要进一步加强HIV阳性配偶的早期发现和针对性预防干预。

Objective To examine transmission route and relationship among newly reported HIV concordant couples in Dehong Prefecture,2015-2019.Methods Demographic and epidemiological characteristics of the newly reported 85 HIV concordant couples were collected to describe their characteristics.Combined with pol gene sequence analysis,the transmission relationship between husband and wife was determined.Results Among the total of 170 participants(85couples),97.1%were heterosexual transmission.The main HIV subtypes were C(33.5%),BC(18.2%),and CRF01_AE(14.1%).27 couples(31.8%)had transmission relationship.17 husbands and 10 wives were prior infection in the family.The HIV subtypes were the same between each couple,mainly C(12 couples)and BC(6 couples).The high-risk behaviors leading to prior infection was mainly the history of non-commercial extramarital sexual contact.Conclusions In Dehong Prefecture,heterosexual transmission was the main infection route for HIV concordant couples.Substantial risks of secondary transmission between HIV-infected couples exist.It suggested the need to further strengthen early detection and targeted interventions among HIV-infected spouses.