我国HIV/AIDS患者HSV感染率及其影响因素研究
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摘要
一.我国HIV／AIDS患者HSV感染率及其影响因素研究
[目的]了解我国不同地区(山西省运城市、浙江省台州市、新疆自治区乌鲁木齐市、云南省德宏州盈江县)HIV／AIDS患者Ⅰ型和Ⅱ型单纯疱疹病毒(HSV-1,HSV-2)的感染率,并分别分析其影响因素。
[方法]对四地区可定期随访的HIV／AIDS患者由经过培训的调查员面对面地进行流行病学问卷调查,调查问卷的内容包括社会人口学特征、性行为特征等。抽取血样运用ELISA法进行血清HSV-1、HSV-2的检测。同时进行血液CD4+T细胞计数。应用Excel2003建立数据库并录入数据,运用SPSS12.0对数据进行统计分析。
[结果]共有1112名研究对象纳入本次研究,其中山西运城288例,浙江台州164例,新疆乌鲁木齐360例,云南盈江300例。研究对象的年龄范围为19-94岁,总体以汉族(54.1%)为主,但在新疆地区则以维吾尔族人为主(88.1%),云南地区傣族研究对象也占相当一部分比例(37.3%)。全部研究对象中,男性(61.5%)、农民(52.4%)、初中和小学文化程度者(71.5%)、在婚者(73.9%)占多数。异性性接触(34.8%)、静脉注射吸毒(31.7%)、有偿采供血(23.0%)是本次研究调查对象的三种主要传播途径。山西运城的研究对象以男性(54.4%)、农民(94.9%)、小学文化程度者(41.5%)、在婚者(95.8%)、经有偿采供血途径感染者(85.0%)占多数：浙江台州的研究对象以男性(67.1%)、商业／服务行业者(45.1%)、初中文化程度者(45.1%)、在婚者(70.1%)、经异性接触感染者(69.5%)占多数；新疆乌鲁木齐的研究对象以男性(52.8%)、无业者(64.4%)、初中文化程度者(44.0%)、在婚者(69.7%)、经静脉注射吸毒感染者(52.8%)占多数；云南盈江的研究对象以男性(76.7%)、无业者(81.7%)、小学文化程度者(54.7%)、在婚者(60.0%)、经静脉注射吸毒感染者(50.0%)占多数。全部研究对象的CD4+T细胞计数小于200个／ul的占23.4%。
所有研究对象的HSV-1感染率为91.5%,四地的HSV-1感染率分别为85.8%、86.6%、97.5%、92.7%。新疆地区的研究对象HSV-1感染率较其他地区高。单因素分析发现这些HIV／AIDS患者的HSV-1感染率与其性别、民族、年龄、文化程度、职业、感染途径等因素有统计学关联。多因素分析的结果提示,女性、民族为维吾尔族是HSV-1感染的相关因素。HSV-2感染率为34.1%,四地的HSV-2感染率分别为13.2%、53.0%、41.4%、35.0%。台州地区的研究对象HSV-2感染率较其他地区高。单因素分析提示艾滋病病人的HSV-2感染率与性别、年龄、民族、婚姻状况、文化程度、职业、感染途径、CD4+T细胞计数等因素有关。多因素分析的结果提示,地区为台州、盈江、女性、民族为傣族或其他少数民族、婚姻状况为离异／丧偶、经采供血途径感染HIV是HSV-2感染的相关因素。
[结论]我国HIV／AIDS患者中HSV-1感染率高,HSV-2感染率稍低于HSV-1,但在经性传播的HIV感染者中感染率高。应加强对HIV／AIDS患者HSV-1和HSV-2的检测,及早治疗,控制HIV／AIDS病情的发展。
二.我国一般人群不同年龄段HSV感染率研究
[目的]了解我国一般人群不同年龄段及性别的单纯疱疹病毒感染率。
[方法]采用横断面整群抽样方法对浙江农村某乡镇一般人口进行调查。从全部72个自然村或村民小组中随机抽取2个,对抽中的2个自然村中所有年龄在1.5至59周岁的常住居民进行血清流行病学调查。在现场对知情同意者抽取静脉血,运用ELISA法进行血清HSV-1、HSV-2的检测,问卷编号与血液样本编号一一对应。应用Excel2003建立数据库并录入数据,运用SPSS12.0对数据进行统计分析。
[结果]共有2190名研究对象参与调查。其中男性1084名,女性1106名。研究对象的年龄范围为1-59岁,平均年龄32.44岁,以25-45岁为主。
总的HSV-1的感染率为89.6%,其中男性和女性感染率分别为为87.7%、91.5%。HSV-1的感染率自5岁以上随年龄增长而增长,5岁以下的儿童的HSV-1感染率为51.0%,在25岁至29岁年龄段HSV-1感染率上升至90.3%。40岁以上年龄段感染率接近于100%。χ2检验发现,男性和女性的HSV-1感染率存在差异,女性感染率(91.5%)高于男性(87.7%)；不同年龄段人群的HSV-1感染率存在差异。
总的HSV-2的感染率为12.1%,男性为10.0%,女性为14.1%。HSV-2的感染率从15-19岁年龄段的7.2%增加至45至49岁年龄段的24.2%。在5至14岁年龄段没有人感染了HSV-2。χ2检验发现,男性和女性的HSV-2感染率存在差异,女性感染率(14.1%)高于男性(10.0%)；不同年龄段人群的HSV-2感染率存在差异。
约11.2%(246／2190)的研究对象同时感染这两种病毒。
[结论]我国一般人群的HSV-1感染率较高,而HSV-2感染率相对较低。
1. Prevalence and Correlates of Herpes Simplex Virus Infections among HIV/AIDS Patients in China
[Objective] To determine the prevalence of herpes simplex virus (HSV) and its correlates among HIV/AIDS patients in four different areas in China(Yun-cheng city of Shanxi province、Tai-zhou city of Zhejiang province、Urumqi city of Xinjiang Uygur Autonomous Region、Ying-jiang county of Yunnan province).
[Methods] All HIV/AIDS patients in the four areas who were alive and traceable were included in this study. Participants were interviewed using standard questionnaires. Aliquots of serum samples were collected.CD4+ cell counts were able to be obtained for the majority of selected study subjects.HSV-1-and HSV-2-specific IgG antibodies were tested. All tests were performed according to the manufacturers'protocols.
[Results] A total of 1112 HIV/AIDS patients were recruited(including 288 from Yun-cheng city,164 from Tai-zhou,360 from Urumqi, and 300 from Ying-jiang). The age group with the highest proportion of participants was 30 to 39 years.The ethnic proportions largely varied by region. In Yun-cheng, all of the sample was ethnic Han. In Tai-zhou most of the sample was ethnic Han. In Urumqi the majority of the sample was Uygur In Ying-jiang 44.3% was ethnic Han,37.3% was ethnic Dai. The entire study sample consisted of more males than females.Most of the total sample classified themselves as peasants. The majority of the total sample was married and most of the sample had finished only primary school or secondary school. The most frequent mode of transmission were through heterosexual transmission, through injection drug use and through plasma/blood donation or transfusion.23.4% of the sample had less than 200 CD4+ cells. Overall, the seroprevalence was 91.5% for HSV-1,34.1% for HSV-2. Univariate logistic regression analysis indicated that, for HSV-1 the prevalence was higher among subjects who were females, aged from 18-29, ethnic Uygur, unemployed, educated at secondary school, and who were heterosexual. Multivariate unconditional Logistic regression indicated that, females, ethnic Uygur were correlated with HSV-1 infection. Univariate logistic regression analysis indicated that, for HSV-2 the prevalence was higher among subjects who were females, aged from 18-29, and ethnic Uygur, unemployed, educated at college or higher levels, who were divorced or widowed,and who were heterosexual. Multivariate unconditional Logistic regression indicated that, Taizhou,Yingjiang,females, ethnic Uygur, who were divorced or widowed, who were plasma/blood donation or transfusion were correlated with HSV-2 infection.
[Conclusion] A substantial proportion of HIV/AIDS patients in China were co-infected with HSV-1 and/or HSV-2. Differential considerations in designing public health and clinical care programs for both HIV and other co-infected pathogenic viruses should be taken into account.
2. Age-specific Herpes Simplex Virus Prevalence among General Population in China.
[Objective] To document age-and gender-specific seroprevalence of herpes simplex virus infections (HSV-1 and HSV-2) in a general Chinese population.
[Methods] A cross-sectional survey was conducted among local residents aged 1-59 years in two randomly selected communities in Zhejiang province in eastern China. HSV-1 and HSV-2 seroprevalence was determined by type-specific antibody tests using an ELISA technique.
[Results] A total of 2,190 residents were analyzed. HSV-1 seroprevalence was 89.6% overall,87.7% for males and 91.5% for females. HSV-1 seroprevalence was nearly 100% among those aged>40 years. Gender difference in HSV-1 seroprevalence was observed for all but only those aged<5 years. HSV-2 seroprevalence was 12.1% overall,10.0% for males and 14.1% for females. HSV-2 seroprevalence was 7.2% among those aged 15-19 years and peaked at 24.2% among those aged 45-49 years. Gender difference in HSV-2 seroprevalence was observed for all age groups. About 11.2% of study subjects were co-infected with both types of HSV.
[Conclusions] HSV-1 was highly prevalent throughout all age groups among community residents in eastern China, whereas HSV-2 was prevalent among sexually active people.
[目的]了解我国不同地区(山西省运城市、浙江省台州市、新疆自治区乌鲁木齐市、云南省德宏州盈江县)HIV／AIDS患者Ⅰ型和Ⅱ型单纯疱疹病毒(HSV-1,HSV-2)的感染率,并分别分析其影响因素。
[方法]对四地区可定期随访的HIV／AIDS患者由经过培训的调查员面对面地进行流行病学问卷调查,调查问卷的内容包括社会人口学特征、性行为特征等。抽取血样运用ELISA法进行血清HSV-1、HSV-2的检测。同时进行血液CD4+T细胞计数。应用Excel2003建立数据库并录入数据,运用SPSS12.0对数据进行统计分析。
[结果]共有1112名研究对象纳入本次研究,其中山西运城288例,浙江台州164例,新疆乌鲁木齐360例,云南盈江300例。研究对象的年龄范围为19-94岁,总体以汉族(54.1%)为主,但在新疆地区则以维吾尔族人为主(88.1%),云南地区傣族研究对象也占相当一部分比例(37.3%)。全部研究对象中,男性(61.5%)、农民(52.4%)、初中和小学文化程度者(71.5%)、在婚者(73.9%)占多数。异性性接触(34.8%)、静脉注射吸毒(31.7%)、有偿采供血(23.0%)是本次研究调查对象的三种主要传播途径。山西运城的研究对象以男性(54.4%)、农民(94.9%)、小学文化程度者(41.5%)、在婚者(95.8%)、经有偿采供血途径感染者(85.0%)占多数：浙江台州的研究对象以男性(67.1%)、商业／服务行业者(45.1%)、初中文化程度者(45.1%)、在婚者(70.1%)、经异性接触感染者(69.5%)占多数；新疆乌鲁木齐的研究对象以男性(52.8%)、无业者(64.4%)、初中文化程度者(44.0%)、在婚者(69.7%)、经静脉注射吸毒感染者(52.8%)占多数；云南盈江的研究对象以男性(76.7%)、无业者(81.7%)、小学文化程度者(54.7%)、在婚者(60.0%)、经静脉注射吸毒感染者(50.0%)占多数。全部研究对象的CD4+T细胞计数小于200个／ul的占23.4%。
所有研究对象的HSV-1感染率为91.5%,四地的HSV-1感染率分别为85.8%、86.6%、97.5%、92.7%。新疆地区的研究对象HSV-1感染率较其他地区高。单因素分析发现这些HIV／AIDS患者的HSV-1感染率与其性别、民族、年龄、文化程度、职业、感染途径等因素有统计学关联。多因素分析的结果提示,女性、民族为维吾尔族是HSV-1感染的相关因素。HSV-2感染率为34.1%,四地的HSV-2感染率分别为13.2%、53.0%、41.4%、35.0%。台州地区的研究对象HSV-2感染率较其他地区高。单因素分析提示艾滋病病人的HSV-2感染率与性别、年龄、民族、婚姻状况、文化程度、职业、感染途径、CD4+T细胞计数等因素有关。多因素分析的结果提示,地区为台州、盈江、女性、民族为傣族或其他少数民族、婚姻状况为离异／丧偶、经采供血途径感染HIV是HSV-2感染的相关因素。
[结论]我国HIV／AIDS患者中HSV-1感染率高,HSV-2感染率稍低于HSV-1,但在经性传播的HIV感染者中感染率高。应加强对HIV／AIDS患者HSV-1和HSV-2的检测,及早治疗,控制HIV／AIDS病情的发展。
二.我国一般人群不同年龄段HSV感染率研究
[目的]了解我国一般人群不同年龄段及性别的单纯疱疹病毒感染率。
[方法]采用横断面整群抽样方法对浙江农村某乡镇一般人口进行调查。从全部72个自然村或村民小组中随机抽取2个,对抽中的2个自然村中所有年龄在1.5至59周岁的常住居民进行血清流行病学调查。在现场对知情同意者抽取静脉血,运用ELISA法进行血清HSV-1、HSV-2的检测,问卷编号与血液样本编号一一对应。应用Excel2003建立数据库并录入数据,运用SPSS12.0对数据进行统计分析。
[结果]共有2190名研究对象参与调查。其中男性1084名,女性1106名。研究对象的年龄范围为1-59岁,平均年龄32.44岁,以25-45岁为主。
总的HSV-1的感染率为89.6%,其中男性和女性感染率分别为为87.7%、91.5%。HSV-1的感染率自5岁以上随年龄增长而增长,5岁以下的儿童的HSV-1感染率为51.0%,在25岁至29岁年龄段HSV-1感染率上升至90.3%。40岁以上年龄段感染率接近于100%。χ2检验发现,男性和女性的HSV-1感染率存在差异,女性感染率(91.5%)高于男性(87.7%)；不同年龄段人群的HSV-1感染率存在差异。
总的HSV-2的感染率为12.1%,男性为10.0%,女性为14.1%。HSV-2的感染率从15-19岁年龄段的7.2%增加至45至49岁年龄段的24.2%。在5至14岁年龄段没有人感染了HSV-2。χ2检验发现,男性和女性的HSV-2感染率存在差异,女性感染率(14.1%)高于男性(10.0%)；不同年龄段人群的HSV-2感染率存在差异。
约11.2%(246／2190)的研究对象同时感染这两种病毒。
[结论]我国一般人群的HSV-1感染率较高,而HSV-2感染率相对较低。
1. Prevalence and Correlates of Herpes Simplex Virus Infections among HIV/AIDS Patients in China
[Objective] To determine the prevalence of herpes simplex virus (HSV) and its correlates among HIV/AIDS patients in four different areas in China(Yun-cheng city of Shanxi province、Tai-zhou city of Zhejiang province、Urumqi city of Xinjiang Uygur Autonomous Region、Ying-jiang county of Yunnan province).
[Methods] All HIV/AIDS patients in the four areas who were alive and traceable were included in this study. Participants were interviewed using standard questionnaires. Aliquots of serum samples were collected.CD4+ cell counts were able to be obtained for the majority of selected study subjects.HSV-1-and HSV-2-specific IgG antibodies were tested. All tests were performed according to the manufacturers'protocols.
[Results] A total of 1112 HIV/AIDS patients were recruited(including 288 from Yun-cheng city,164 from Tai-zhou,360 from Urumqi, and 300 from Ying-jiang). The age group with the highest proportion of participants was 30 to 39 years.The ethnic proportions largely varied by region. In Yun-cheng, all of the sample was ethnic Han. In Tai-zhou most of the sample was ethnic Han. In Urumqi the majority of the sample was Uygur In Ying-jiang 44.3% was ethnic Han,37.3% was ethnic Dai. The entire study sample consisted of more males than females.Most of the total sample classified themselves as peasants. The majority of the total sample was married and most of the sample had finished only primary school or secondary school. The most frequent mode of transmission were through heterosexual transmission, through injection drug use and through plasma/blood donation or transfusion.23.4% of the sample had less than 200 CD4+ cells. Overall, the seroprevalence was 91.5% for HSV-1,34.1% for HSV-2. Univariate logistic regression analysis indicated that, for HSV-1 the prevalence was higher among subjects who were females, aged from 18-29, ethnic Uygur, unemployed, educated at secondary school, and who were heterosexual. Multivariate unconditional Logistic regression indicated that, females, ethnic Uygur were correlated with HSV-1 infection. Univariate logistic regression analysis indicated that, for HSV-2 the prevalence was higher among subjects who were females, aged from 18-29, and ethnic Uygur, unemployed, educated at college or higher levels, who were divorced or widowed,and who were heterosexual. Multivariate unconditional Logistic regression indicated that, Taizhou,Yingjiang,females, ethnic Uygur, who were divorced or widowed, who were plasma/blood donation or transfusion were correlated with HSV-2 infection.
[Conclusion] A substantial proportion of HIV/AIDS patients in China were co-infected with HSV-1 and/or HSV-2. Differential considerations in designing public health and clinical care programs for both HIV and other co-infected pathogenic viruses should be taken into account.
2. Age-specific Herpes Simplex Virus Prevalence among General Population in China.
[Objective] To document age-and gender-specific seroprevalence of herpes simplex virus infections (HSV-1 and HSV-2) in a general Chinese population.
[Methods] A cross-sectional survey was conducted among local residents aged 1-59 years in two randomly selected communities in Zhejiang province in eastern China. HSV-1 and HSV-2 seroprevalence was determined by type-specific antibody tests using an ELISA technique.
[Results] A total of 2,190 residents were analyzed. HSV-1 seroprevalence was 89.6% overall,87.7% for males and 91.5% for females. HSV-1 seroprevalence was nearly 100% among those aged>40 years. Gender difference in HSV-1 seroprevalence was observed for all but only those aged<5 years. HSV-2 seroprevalence was 12.1% overall,10.0% for males and 14.1% for females. HSV-2 seroprevalence was 7.2% among those aged 15-19 years and peaked at 24.2% among those aged 45-49 years. Gender difference in HSV-2 seroprevalence was observed for all age groups. About 11.2% of study subjects were co-infected with both types of HSV.
[Conclusions] HSV-1 was highly prevalent throughout all age groups among community residents in eastern China, whereas HSV-2 was prevalent among sexually active people.
引文
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