广西HIV新近感染病例的流行病学调查分析

Epidemiological investigation on HIV newly infected cases in Guangxi

目的通过对新近感染艾滋病病毒（HIV）病例的流行病学调查,实时动态反映广西艾滋病疫情的流行特征和传播模式,为精准防控提供科学参考依据。方法匹配新发现报告病例的既往HIV抗体检测记录,甄别新近感染病例,面对面开展流行病学调查,重点了解人口学基本特征、高危行为史、传播来源、CD4~＋T淋巴细胞（简称CD4细胞）检测情况等。结果调查的219例新近感染病例中,男性占66.7%,20~59岁年龄组占77.2%,汉族占68.0%,已婚有配偶者占50.2%,初中以下文化程度占70.3%,农民占57.1%;异性性传播占71.7%,同性性传播占27.9%。97.7%的新近感染病例报告了首次CD4细胞检测结果,中位数为334个/mm^3,其中200~349个/mm^3占35.5%,〈200个/mm^3占19.2%。结论广西新近感染病例流行病学特征与近年来新报告病例特征基本一致,但部分地区男男性行为者或许已经成为新发感染的主要人群,亟待加强针对性防控。部分新近感染者CD4细胞水平下降快,是否为快速进展型有待加大样本量进行深入研究。

Objective To explore epidemiological characteristics of HIV newly infected cases in Guangxi and provide information to improve the intervention measures.Methods The newly infected cases were identified based on their HIV antibody testing records,and face to face interviews were performed to collect information on their characteristics,high risk behavior,transmission route and CD4＋T cells,etc.Results A total of 219 cases were enrolled in the survey.Of all the participants,there were 66.7% males,77.2% between 20-59 age group,68.0% Han,50.2% married with spouse,70.3% below junior high school,and 57.1% peasants.The proportions of heterosexual and homosexual transmission were 71.7% and 27.9% respectively.97.7% of them reported the first CD4 testing results with a median of 334 cells/mm^3,and among the detected,200-349 cells/mm^3 accounted for 35.5%and less than 200 cells/mm^3 for 19.2%.Conclusion The characteristics of newly infected cases are similar to those of newly reported cases in recent years in Guangxi.MSM have become the main population of new infections in some areas,and it is urgent to strengthen the targeted prevention and control.Further investigation is needed to know whether some newly infected cases have rapid progression due to their CD4 counts dropping sharply.