HIV单阳家庭配偶阳转情况及先证者生存分析

Analysis of the positive conversion rate of negative spouse and survival analysis on HIV sero-discordant couples

目的分析安徽省阜阳市艾滋病病毒(human immunodeficiency virus,HIV)单阳家庭配偶阳转的比例及先证者抗病毒治疗的生存分析。方法资料来源于艾滋病综合防治数据信息系统中的病例报告数据库,筛选出1997年9月1日-2018年9月1日间确诊的HIV单阳家庭,建立队列,根据研究对象进行抗病毒治疗的时机,将研究对象分为未治疗组、常规治疗组和提前治疗组,比较三组阴性配偶阳转率及生存状况。结果共纳入单阳家庭598户,三组人群总随访时间分别为:258.92人年、4987.17人年和862.25人年,HIV阳转率分别为6.18/100人年,0.48/100人年和0.23/100人年,多因素Cox比例风险模型显示:相对于未治疗组,常规治疗组(HR=0.052,95%CI:0.037~0.074)和早期治疗组(HR=0.011,95%CI:0.003~0.035)患者死亡的风险有下降的趋势;女性死亡风险低于男性(HR=0.667,95%CI:0.472~0.944);年龄越大,其死亡风险越高(HR=1.041,95%CI:1.026~1.056),而相对于农民,无业者死亡风险较高(HR=1.571,95%CI:1.037~2.381)。结论应针对不同特征的单阳家庭制定有针对性的干预措施,以推动尽早开展抗病毒治疗。

Objective To analyze the positive conversion rate of negative spouse and the survival analysis on HIV sero-discordant couples.Methods Data were collected from the case report database of the integrated AIDS prevention and control data and information system.HIV sero-discordant couples diagnosed between September 1,1997 and September 1,2018 were recruited into the cohort.The participants were divided into three groups as untreated subgroup,routine treatment subgroup and early treatment subgroup according to the situation when they started HIV treatment.The positive conversion rate of negative spouse and the survival were compared among the three subgroups.Results 598 HIV sero-discordant couples were recruited and the overall survival time of the three subgroups were 258.92,4987.17 and 862.25 person-year.The rate of positive conversion were 6.18/100,0.48/100 and 0.23/100 person-year.Multivariate Cox regression model showed that the hazard ratio of routine treatment subgroup(HR=0.052,95%CI:0.037-0.074)and early treatment subgroup(HR=0.011,95%CI:0.003-0.035)were lower than untreated subgroup.The risk of death of women was lower than that of men(HR=0.667,95%CI:0.472-0.944);the older the age,the higher the risk of death(HR=1.041,95%CI:1.026-1.056);and the risk of death of the unemployed is higher than that of farmers(HR=1.571,95%CI:1.037-2.381).Conclusion Targeted interventions methods and early antiviral therapy should be taken urgently for sero-discordant couples.