中国西南地区2008—2013年HIV抗体检测结果与分析

Detection and analysis of HIV antibody in a large teaching hospital from 2008 to 2013.

目的探讨中国西南地区大型综合性医院门诊及住院患者HIV感染的情况，为临床应对HIV感染提供科学依据。方法2008年至2013年，采用梅里埃酶联免疫吸附法第三代抗体检测试剂或罗氏电化学发光第四代抗原抗体检测试剂为644208例就诊患者行HIV抗体初筛，采用原检测试剂和丽珠酶联免疫吸附法抗体检测试剂行复检，阳性反应标本送往四川省疾病预防控制中心或四川大学华西医院HIV确证实验室采用免疫印迹法进行确证。结果在检测的644208份标本中共1917例（0．30％）确证为HIV-1抗体阳性，其中599例（0．75％）来自门诊，住院患者1318例（0．23％），主要依次分布于门诊、感染中心、皮肤科、呼吸科、中西医科；男性1534例，女性383例，年龄分布主要集中于青壮年（1383例）；以异性传播为主要传播方式（1228例），同性传播所占比例呈递增趋势。结论HIV感染率呈逐年递增的趋势，异性传播为主要途径同性传播逐渐增多，医务人员应加强自我保护意识，减少职业暴露，避免医疗纠纷，加强全民普及HIV相关知识。

Objective To provide the scientific basis prevention of HIV infection in clinic, we studied the infection status and tendency of HIV among outpatients and inpatients in a large teaching hospital of southwest China. Methods From 2008 to 2013, the third generation Merieux enzyme-linked immunosorbent method of antibody or the fourth generation Roche electrochemiluminescence immunoassay were adopted in 644208 clinic patients for HIV antibody screening. The original detection method and Livzon enzyme-linked immunosorbent method of antibody were used for re-detection, and the positive specimens were sent to the local Center for Disease Control and Prevention or West China Hospital HIV confirmation laboratory for confirmation using western blot assay. Results A total of 1917 patients （0. 30% ） were confirmed as HIV-1 antibodies positive, of which, 599 cases were outpatients （0. 75% ）, 1318 cases were inpatients （0. 23% ）. These patients were mainly distributed in the department of outpatient service, department of infection center, department of dermatology, department of pneumology, department of integrated Chinese and western medicine. 1917 including 1534 male cases and 383 female cases, most of HIV positive patients were distributed in young adults （ 1383 cases）. Patients living with HIV were mainly infected through heterosexual transmitted route （1228 cases ）, an increasing trend of proportion of Homosexual transmission was noticed. Conclusion Rate of HIV infection was increasing year by year. Heterosexual transmission is the main way to spread and homosexual transmission gradually increased. Medical staff should enhance consciousness of self-protection, reduce hospital-acquired infection due to occupational exposure, avoid occurrence of medical dispute. National health education on HIV knowledge should be popularized.