经性传播与供／受血传播人类免疫缺陷病毒感染者特点分析

Epidemiological characteristics of patients acquiring human immunodeficiency virus infection through sexual contact or blood transfusion

目的比较经性传播与经供／受血传播HIV感染者的临床特点。方法调查679例HIV／AIDS患者病史，检测CD4^＋T淋巴细胞计数、梅毒抗体及HIV-1亚型，并检查其配偶HIV抗体；女性患者检测人类乳头瘤病毒（HPV）分型。实验数据采用两样本t检验和卡方检验。结果异性性传播组348例，供／受血传播组331例，性传播组检测HIV-1亚型120例，90％（108／120）为重组亚型；供／受血传播组检测107例，均为B’亚型。HIV异性传播组和供／受血传播组分别检测可治愈的性病（STDs）293例和156例，其患病率分别为34．1％（100／293）和5．8％（9／156）（X^2=44．541，Pd0．01）。对HIV异性传播组和供／受血传播组的43例和138例女性患者进行HPV检测，其感染率分别为67．4％（29／43）和26．8％（37／138）（x^2=23．361，P〈0．01）。HIV异性传播组的348例和供／受血传播组的331例患者中，HIV夫妻传播率分别为48．9％（170／348）和23．3％（77／331）（X^2=47．991，P〈0．05）。结论经性传播HIV者确诊晚，发生传播的风险较高，合并其他性病和HPV感染更常见。

Objective To compare the epidemiological characteristics of patients acquiring human immunoddiciency virus （H1V） infection through sexual contact or blood transfusion. Methods A total of 679 HIV/AIDS patients were recruited. The informed consents were obtained from all participants. CD4＋T lymphocyte count, anti-syphilis and HIV-1 subtype of recruited cases were tested, and anti-HIV of their spouses was tested. Human papillomavirus （HPV） genotyping was performed in female patients. The data were analyzed by t test and chi square test. Results There were 348 cases in heterosexual transmission group （STG） and 331 in blood transfusion group （BTG）. HIV-1 genotyping was performed in 120 STG cases and 90 % （108/120） were mixed genotypes ; HIV- 1 genotypes in 107 BTG cases were all subtype B＇. Curable sexual transmitted diseases （STDs） in STG and BTG were identified in 293 and 156 cases, respectively. The incidence of cSTDs were 34.1 （100/293） inSTGand 5.8%（9/156） inBTG （X^2=44.541, P〈0.01）. Forty-three females in STG and 138 females in BTG were tested for HPV, and the HPV infection rates ware 67.4% （29/43） and 26.8% （37/138）, respectively （X^2=23.361, P〈0.01）. Among 348 cases in STG and 331 cases in BTG, the rate of HIV transmission between couples was 48. 9% （170/348） and 23. 3% （77/331）, respectively （X^2 =47. 991, P〈0.05）. Conclusions The diagnosis of HIV infection acquired through sexual contact is usually late, which results in a relatively high risk for viral transmission. Furthermore, the co-infection of HIV and HPV or other sex transmission disease is common.