2001-2015年我国术前和受血前群体HIV筛查阳性率的研究

Ecological analysis on national trends of HIV prevalence among clinical surgery patients and pre-transfusion patients during 2001-2015

目的掌握中国临床术前和输血前患者艾滋病病毒(HIV)阳性检出率分布及其变化趋势,为开展有针对性HIV防控提供理论依据。方法检索并提取2001-2015年中国临床术前和输血前人群HIV筛查数据,使用生态学分析描述其HIV感染率水平、分布特征和随时间的变化趋势。结果共纳入351篇符合要求的中文文献,临床术前和输血前患者筛查HIV总阳性率为0.14%(5 377/3 730 591)。研究对象HIV阳性率存在地区差异性,由高到低依次为西部0.35%(3807/1 083 693),中部0.09%(999/1 082 922);东南部0.05%(522/1 046 453);东北部0.01%(49/517 523)。研究对象HIV阳性率随研究时间呈上升趋势,从2001-2005年间0.08%(452/579 802)上升至2011-2015年间的0.17%(1 128/646 196)(趋势性P值<0.01)。除东北地区、高收入水平地区及HIV低流行水平地区外,其他区域研究对象的HIV阳性检出率随研究时间均呈上升趋势(趋势性P值均<0.01)。结论近年来中国多区域临床术前和输血前患者的HIV检出率水平较高且呈上升趋势,值得关注。相关部门需加强对其HIV疫情的监测和防控,并通过开展相关教育防止临床医务人员的HIV职业暴露。

Objective To describe and analyze the situation and the changing trend of HIV prevalence among clinical surgery patients and pre-transfusion patients in recent years in China to learn the features of HIV epidemic and provide information for conducting target HIV prevention and control. Methods Literatures containing the data of HIV prevalence among clinical surgery patients and pre-transfusion patients were retrieved and analyzed during the period of 2001 to 2015. Ecological analysis and Cochran-Armitage Trend Test were conducted based on the collected data from retrieved literatures. Results Three hundred and fifty-one eligible literatures were selected. The pooled prevalence of HIV among the subjects we studied was 0.14 %. The distribution of HIV prevalence differed greatly in different geographic regions, ranging the western region 0.35%, the central region 0.09%, the southeast region 0.05% and the northeast region 0.01%（P〈0.01）. There was a significant increase of HIV prevalence with the study period, increasing from 0.08% in 2001-2005 to 0.17% in 2011-2015（trend P〈0.01）. Except the northeast region, the prevalence of HIV showed a significantly rising trend in other regions（trend P〈0.01）. Conclusion The prevalence of HIV among national clinical surgery patients and pre-transfusion patients has reached a high level and showed a rapid increasing trend. Related health sectors should strengthen the HIV epidemic surveillance and prevention.