中国六省儿童HIV感染者的流行病学调查

Epidemiology of Pediatric HIV Infection in Six Provinces of China

目的了解中国六省儿童HIV感染者的流行病学状况。方法对6个艾滋病高发省份的儿童感染者进行横断面调查,采集患者人口学、感染途径、诊断时间、临床分期、实验室检测等数据。结果共650例患儿入选,男405例,女245例,平均年龄(7.9±3.2)岁,可能感染到确诊的平均时间间隔为(7.1±3.2)年。依次分布于河南570例(87.7%),广西23例(3.5%),云南21例(3.2%),湖北19例(2.9%),安徽10例(1.5%),山西7例(1.1%)。其中母婴传播488例(75.1%),输血及血制品传播102例(15.7%),静脉吸毒传播3例(0.5%)。以采供血为主要传播途径的省份(包括河南、山西、湖北、安徽)和以静脉吸毒为主要传播途径的省份(包括广西、云南)感染者的平均年龄分别为(8.1±3.2)和(5.4±2.2)岁,两组相比差异有显著性(P<0.001)。178例(39.3%,178/453)符合接受抗病毒治疗标准,其中133例(74.7%,133/178)未接受治疗,45例(25.3%,45/178)采用成人药物治疗。结论母婴传播是儿童感染HIV的主要途径,应当加强我国儿童HIV感染者的诊断和治疗工作。

Objective To investigate the epidemiology of pediatric human immunodeficiency virus （HIV） infection in six provinces of China. Methods A cross-sectional study was conducted in six provinces with the highest HIV prevalence. Surveys on demographics and HIV-related questions （transmission modes, time of diagnosis, clinical stage, laboratory test） were distributed to clinicians in these provinces. Descriptive and bivariate analyses were performed on the completed surveys. Results Survey results of 650 children [405 males and 245 females ; average age ： （ 7.9 ± 3.2 ） years ] were eligible for analysis. The interval between possible transmission and diagnosis was （7.1 ± 3.2 ） years. The location distribution was as follows ： 570 cases （87.7%） in Henan Province, 23 cases （3.5%） in Guangxi Province, 21 cases （3.2%） in Yunnan Province, 19 cases （2.9%） in Hubei Province, 10 cases （ 1.5% ） in Anhui Province, and 7 cases （1.1%） in Shanxi Province. Transmission routes included mother-to-child transmission （75.1% ） , blood transfusion/ plasma donation （ 15.7 % ）, and injecting drug use （ IDU,0. 5% ）. Former plasma donation （FPD） was the main transmission route in some provinces （ Henan, Shanxi, transmission route in other provinces （ Guangxi and Yunnan）. Hubei, and Anhui）, The average age in the while IDU was the main FPD provinces was significantly higher than that in IDU provinces [ （ 8.1 ± 3.2） vs. （5.4 ± 2.2） years, P 〈 0. 001 ]. Among 178 patients in all six provinces who required treatment （on the basis of CD4 count or WHO staging）, 133 （ 74.7 % ） did not receive treatment and 45 （25.3 % ） received antiretrovirus therapy. Conclusion Motherto-child transmission is the main transmission mode in pediatric patients. Efforts should be made to strengthen the diagnosis and treatment of pediatric HIV/AIDS patients.