新疆伊犁州HIV单阳家庭早期抗病毒治疗防治效果研究

Study on the preventive and curative effect of early antiretroviral therapy in singlepositive HIV families in Yili Prefecture of Xinjiang

目的探讨早期抗病毒治疗对新疆伊犁州HIV单阳家庭的治疗效果以及配偶间传播的预防效果。方法选取2011～2014年新疆伊犁州接受早期抗病毒治疗的HIV单阳家庭245户，对其进行问卷调查，并通过艾滋病综合防治数据信息系统收集其随访资料，包括病毒载量、CD4^＋T淋巴细胞水平以及配偶阳转等情况。采用秩和检验、χ^2检验进行组问比较，Cox比例风险模型进行影响因素分析。结果早期抗病毒治疗后，阳性配偶的免疫重建率为76．3％（187／245），病毒抑制率为78．8％（193／245）。不同依从性、不同参与治疗意愿及治疗后是否出现不良反应的阳性配偶之间的病毒抑制率比较，差异有统计学意义（P〈0．05）。245户单阳家庭累计随访395人年，6例阴性配偶HIV抗体阳转，阳转率（发病密度）为1．5／100人年。构建Cox比例风险模型对性别、族别、依从性、病毒抑制及免疫重建等进行单因素和多因素分析发现，差异均无统计学意义（P均〉0．05）。结论新疆伊犁州HIV单阳家庭早期抗病毒治疗后，阳性配偶治疗效果显著，阴性配偶阳转率处于较低水平，应进一步加强早期抗病毒治疗工作。同时关注HIV单阳家庭的依从性和参与治疗的主动性。

Objective To explore the curative effect of early antiretroviral therapy and preventive effect for heterosexual transmission between spouses in single-positive HIV families in Yili Prefecture of Xinjiang. Methods A total of 245 single-positive HIV families treated by early antiretroviral therapy in Yili Prefecture of Xinjiang from 2011 to 2014 were selected, then a questionnaire survey was performed; the follow-up data was collected through AIDS comprehensive prevention and treatment data information system, including viral load, CD4^＋ T lymphocytes levels, and seroconversion of spouses. Comparison among groups was conducted using rank-sum test and χ^2 test; the influencing factors were analyzed based on Cox proportional hazard regression model. Results After early antiretroviral therapy, the immunologic reconstitution rate of positive spouses was 76. 3% （ 187/245）, the viral inhibition rate was 78.8% （ 193/245 ） . There were statistically significant differences in the viral inhibition rate among the positive spouses with different compliance, initiative, and adverse reactions after treatment （P〈0.05） . All the 245 single-positive families were followed up by 395 person-years, six HIV seroconversion spouses were identified, the seroconversion rate was 1.5 per 100 person-years. Univariate and multivariate analysis by constructing Cox proportional hazards model showed that there was no statistically significant difference in gender, nationality, compliance, viral inhibition, and immunologic reconstitution （P〉0. 05） . Conclusion The curative effect of early antiretroviral therapy in single-positive HIV families in Yili Prefecture of Xinjiang is significant for positive spouses, the seroconversion rate is low, early antiretroviral therapy should be further enhanced. Meanwhile, the compliance and initiative of treatment should be paid attention to in single-positive HIV families.