2007—2017年北京某综合医院患者HIV检测结果分析

Analysis of HIV test results of patients in a general hospital in Beijing during 2007-2017

目的了解艾滋病病毒(HIV)抗体检测阳性者的流行病学特点,为区域性HIV筛查及防治提供依据。方法选取2007—2017年北京某综合医院门诊与住院患者HIV抗体初筛阳性标本,送至北京市朝阳区疾病预防控制中心进行确证,对相关数据进行描述性流行病学分析。结果 2007—2017年共进行HIV筛查310 415人次,初筛阳性320例(0.10%),确证阳性277例(0.09%)。HIV检测阳性率随年份变化而不同,差异有统计学意义(趋势χ~2=33.80,P<0.000 1)。2012—2017年HIV检测阳性率是2007—2011年的3.13倍(χ~2=40.02,P<0.000 1)。HIV抗体确证阳性者以男性(95.31%)、20～39岁(81.23%)、已婚(58.12%)、外地户籍者(79.06%)为主,男女比例20.31∶1,传播途径以男男同性性传播为主(95.31%)。排名前3位的职业依次是干部职员和工人(32.49%)、家务及待业(26.35%)、商业服务(18.05%);就诊科室主要分布在皮肤科(41.52%)、内科(19.49%)、外科(13.72%)和体检中心(11.19%)。结论 2007—2017年北京某综合性医院HIV检测阳性率呈升高趋势,需加强对大型综合性医院就诊患者的检测。男男性行为者、20～39岁、外地户籍等人群需作为艾滋病防控宣传和咨询检测的重点人群。HIV抗体阳性者职业覆盖社会多个行业,就诊科室分布广泛,医务人员应提高自我防护意识以避免职业暴露风险。

Objective To understand the epidemiological characteristics of patients with HIV antibody positive,and to provide the basis for HIV regional screening and prevention.Methods The serum HIV antibody was screened among the inpatients or outpatients of a general hospital of Beijing between Jan 2007 and Dec 2017,and the serums with positive results were sent to Chaoyang district center for disease control and prevention for confirmation.Descriptive epidemiological analysis was used to explore the distribution and secular trend.Results A total of 310 415 patients were screened,with 320(0.10%)patients HIV positive,and 277(0.09%)were confirmed as HIV infection.The positive HIV rate varied year by year,and the difference was statistically significant(trendχ~2=33.80,P<0.000 1).The positive HIV rate during 2012-2017 was 3.13 times higher than that during 2007-2011(χ~2=40.02,P<0.000 1).The patients with HIV confirmation were predominated by male(95.31%),aged between 20-39 years(81.23%),with 58.12%married and 79.06%non-Beijing residents.The ratio of male to female was 20.31 to 1,and 95.31%was infected via homosexual intercourse.32.49%of them were cadres,staff and workers,26.35%were engaged in housework or unemployed,and 18.05%were involved in business services.They were mainly from the department of dermatology(41.52%),internal medicine(19.49%),surgery(13.72%)and health examination center(11.19%).Conclusion The HIV positive rate of the patients in a general hospital of Beijing is increasing from 2007 to 2017,and it is necessary to strengthen HIV detection in general hospitals.Men who have sex with men(MSM),age between 20-39 years old and non-Beijing residents should be the key groups to receive AIDS education,counseling and testing.HIV-positive patients can be detected from many medical departments of a hospital,and clinical staff should receive further training to avoid occupational exposure.