1988～1998年深圳市艾滋病流行病学分析

Analysis on HIV/AIDS Epidemic in Shenzhen

目的 通过对深圳市1988～1998年HIV/AIDS临床资料、人口学资料和分子流行病学调查数据进行研究,了解HIV在深圳市的流行特点、阶段、模式、分析其传染来源和流行趋势,为制定有效的预防控制措施提供科学依据。方法 应用ELISA法对不同监测人群进行HIV抗体检测,抗体阳性者经蛋白印迹(WB)法确认后进行流行病学调查及个案分析;同时采集感染者外周血淋巴细胞提取核酸后应用Nested-PCR技术扩增HIV-1 env基因,并进行序列测定、基因离散率和系统树分析。结果 1988～1998年在225 354人中发现48例HIV感染者,总感染率为21.3/10万;感染主要通过性途径(39.6％)和静脉吸毒(35.4％);48例HIV/AIDS病人中外来流动人员占88.9％;女性感染者数量迅速上升并于1997年超过男性;目前在深圳市流行HIV-1毒株主要为B、C、E三种亚型。结论 1996年以后HIV/AIDS在深圳市的流行已进入快速增长期,主要经性途径传播的HIV-1 B、C、E三种亚型将在性乱者和吸毒者等主要感染群体中播散蔓延;随着女性感染者不断增多,母婴传播的危险性日渐增加。

To analyze the epidemic characterization, phases, model and trend of HIV/AIDS in shenzhen, and provide scientific evidence based on data from HIV/AIDS surveillance, molecular epidemiological survey and demography from 1988 to 1998. Methods The serum samples collected from the different surveillance populations were tested for HIV antibody by ELISA and WB. Also, the epidemiological investigation target on HIV infected individuals was conducted. HIV - 1 env gene was amplified by nested - PCR from uncultured peripheral blood mononuclear cells (PBMCs) from the HIV positives. Results 48 HIV positive cases among 225 354 samples from all groups investigated were identified to be infected with HIV mainly through sexuality (39.6%) and intravenous injecting drug (35.4%), and the epidemic strains among them were HIV- 1 B, C and E subtypes. Of 48 HIV individuals 88.9% of them were migrant people from abroad or other parts of China. The number of HIV infected women had been rapidly growing since 1996. Conclusion The HIV/AIDS epidemic in Shenzhen has come into the rapid growing phase since 1996. The subtypes of HIV - 1 B, C and E will be spreading among the populations such as sexually promiscuous population and IVDUs. The finding of HIV infected women growing more rapidly than men since 1997 indicates that the risk of HIV transmission of mother to child is gradually rising.