湖州市抗病毒干预对配偶间HIV传播的抑制作用研究

Inhibitory effect of antiviral intervention on transmission of HIV among spouses in Huzhou city

目的:分析湖州市抗病毒干预对配偶间HIV传播的抑制作用。方法:回顾性分析308例HIV抗体阳性者及其阴性配偶的临床资料,根据原阳者治疗情况分为抗病毒组(n=158)、未抗病毒组(n=150)。比较两组原阳者年龄、性别、文化程度、感染时间、性行为频率、安全套使用情况,原阳者首次检测及末次随访的白细胞计数(WBC)、红细胞计数(RBC)、红细胞血红蛋白(CH)、红细胞体积(CV)等血液学指标、CD4计数、CD8计数等免疫指标及HIV病毒载量,比较两组患者患者随访时间、随访期间HIV检测次数、随访期间阴性配偶转阳率。结果:两组患者原阳者性别、年龄、文化程度、感染时间、每月性行为次数、安全套使用情况的差异均无统计学意义(均P>0.05)。随访时间及随访期间HIV人均检查次数的差异均无统计学意义(均P>0.05)。两组患者患者随访1年及2年的配偶转阳性率无统计学意义(P>0.05),抗病毒组随访3年的转阳率为0.93%(1/108),低于未抗病毒组的7.69%(8/104),差异具有统计学意义(P<0.05)。抗病毒组与未抗病毒组首次检测时的WBC、RBC、CH、CV、CD4+计数、CD8+计数、HIV载量的差异无统计学意义(P>0.05);抗病毒组末次随访的WBC、RBC、HIV病毒载量低于未抗病毒组,CH、CV、CD4+计数、CD8+计数高于未抗病毒组,差异具有统计学意义(P<0.05)。结论:抗病毒干预可有效抑制病毒复制,改善原阳者贫血症状,促进其免疫力的恢复,有利于降低配偶间HIV传播风险,值得推广。

Objective： To analyze the inhibitory effect of antiviral intervention on the transmission of human immunodeficiency virus（ HIV） among spouses in Huzhou. Methods： Retrospective analysis of the clinical data of308 cases of HIV antibody positive and negative spouse was conducted and the subjects were divided into antiviral group（ n = 158） and non-antiviral group（ n = 150） according to the treatment of the original positive patients.Age,sex,educational level,time of infection of the original positive patients,frequency of sexual behavior,condom use,the hematological indicators of the white blood cell count（ WBC）,red blood cell count（ RBC）,erythrocyte hemoglobin（ CH）,red blood cell volume（ CV）,the immune indicators of CD4 count,CD8 count,the HIV viral load at first detection and last follow-up,follow-up time,times of HIV tests and the rate of negative spouse turning positive during follow-up were compared between the two groups. Results： There were no significant differences in the age,sex,educational level,time of infection of the original positive patients,frequency of sexual behavior,condom use between the two groups（ P 〉0. 05）. There were no significant differences in the follow-up time,the times of HIV examinations between the two groups（ P 〉0. 05）. There was no significant difference in the rate of negative spouse turning positive between the two groups within 1 year and 2 years follow up（ P 〉0. 05）. The rate of negative spouse turning positive of the antiviral group was 0. 93%（ 1/108） within the 3-year follow up,which was lower than7. 69%（ 8/104） in the non-antiviral group（ P 〈0. 05）. There were no significant differences in WBC,RBC,CH,CV,CD4 ＋ count,CD8 ＋ count and HIV viral load between the antiviral group and the non-antiviral group at first detection and last follow-up（ P 〉0. 05）. The WBC,RBC and HIV viral load at the last follow-up were lower than those in the non-antiviral group（ P 〈0. 05）,while the CH,CV,CD4 ＋ count,CD8 ＋ count at the last follow-up were higher than those in the non-antiviral group（ P〈0. 05）. Conclusions： Antiviral intervention can effectively inhibit the virus replication,improve the original positive anemia symptoms,and promote the recovery of immune system,which is conducive to reducing the risk of HIV transmission between spouses and worthy of promoting.