北京市2009-2011年部分新报告HIV病例中新发感染的流行病学分析

Epidemiological analysis on recent infected HIV-1 patients among newly reported HIV cases in Beijing, from 2009 to 2011

目的了解北京市近年新报告HIV病例和HIV-1新发感染病例流行特征及相关影响因素。方法对北京市2009年第一季度、2010年第一季度、2011年第二季度新报告HIV阳性并符合BED捕获酶联免疫法（BED—CEIA）检测标准的血清样本进行检测。根据社会人口学特征对新报告HIV病例及BED阳性病例分组并计算构成比，分析相关影响因素。结果2009年第一季度、2010年第一季度、2011年第二季度北京市新报告HIV并符合BED—CEIA检测标准的病例分别为274、236、356例，BED阳性率分别为35．0％、31．8％、33．7％，各年度新报告病例主要集中在男性（89．1％、88．6％、91．9％）、20～39岁（77．4％、75．8％、82．O％）、汉族（77．7％、88．6％、85．7％）及外地户籍人口（74．1％、80．5％、2011年数据缺失），经性传播病例构成比呈上升趋势（67．5％、76．2％、86．8％），其中男男性行为者（MSM）传播上升明显（44．9％、45．3％、62．6％），注射吸毒出现一定的下降（15.3％、8．1％、9．0％）。各年度BED阳性与阴性新报告HIV病例在性别、传播途径及样本来源构成比方面的差异有统计学意义（P〈0．05），病例年龄及婚姻状况构成比差异无统计学意义（P〉0．05）。结论近年北京市MSM人群在新报告HIV病例及HIV-1新发感染病例中所占比重较大，呈继续上升趋势。MSM人群是北京市HIV感染的高危人群。

Objective To understand the epidemiologic characteristics on newly reported HIV cases and those recently infected HIV-1 cases in the past few years in Beijing so as to find out their correlates. Methods All the qualified newly reported HIV serum samples from both the first quarters of 2009,2010 and the second quarter of 2011 in Beijing, were tested using the BED HIV-1 incidence capture enzyme immunoassay （BED-CEIA） to identify those recent HIV-1 infection （BED positive） samples and related socio-demographic characteristics. The proportions of BED positives were determined and the correlates analyzed by SPSS software. Results The Annual qualified newly reported HIV serum samples of each year from Beijing were 274,236 and 356, with BED positive rate among them as 35.0%, 31.8% and 33.7%, respectively. The majority of newly reported HIV cases of each year were males （89.1%, 88.6%, 91.9% ）, range of age as 20-39 years （77.4%, 75.8%, 82.0% ）, Han nationality （77.7%, 88.6%, 85.7% ）, and most of them were not permanent residents of Beijing （74.1%, 80.5%, 2011 data missed）. The proportions of patients through sexual transmission showed upward trend（67.5%, 76.2%, 86.8% ）. Especially in the ＇man having sex with man＇ （MSM） group, it showed a significantly increase （44.9%, 45.3%, 62.6% ）. The proportions of injection drug users （ 15.3%, 8.1%, 9.0%） declined to some extent during this period. Data from statistics indicated that the proportions of BED positives among newly reported HIV cases of each year were significantly correlated to factors as patients＇ sex, transmission route and source of samples, but not significantly correlated to patents＇ age or marital status. Male cases accounted for 96.9% and MSM accounted for 73.5% of all the BED-positives during 2009-2011. Conclusion MSM accounted for both large portion of newly reported HIV cases and recent HIV-1 infections which suggested an increasing trend in 2009-2011. It seemed that the characteristic and changing trends of HIV epidemic in Beijing was oriented by MSM population in the last years.