246例HIV感染者的流行病学特点及梅毒感染情况
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摘要
目的分析2012—2017年北京某综合医院人类免疫缺陷病毒(human immunodeficiency virus,HIV)抗体检测阳性者的流行病学特点及梅毒感染情况,为区域性HIV筛查及防治提供依据。方法对2012—2017年北京某综合医院门诊与住院患者中经HIV抗体初筛和确认的HIV感染者相关数据进行描述性流行病学分析。结果 2012—2017年共进行HIV筛查222 550人次,初筛阳性285例(0.13%),确证阳性246例(0.11%)。各年HIV阳性率较稳定,上升趋势不明显。HIV抗体确认阳性者以男性为主,占96.34%,男女比例26.33∶1,年龄上以20～39岁年龄段为主(82.52%),外省市户籍者(84.96%)居多,婚姻状况以已婚为主(56.50%),且已婚比例随时间有升高趋势(P<0.05);传播途径上均为性传播,以男男同性性传播为主(96.34%)。就诊科室主要分布在皮肤科(43.50%)、内科(16.67%)、外科(13.41%)和体检中心(11.79%),在整个内科来源的HIV阳性者中,消化内科占的比例为65.85%。HIV阳性者合并感染梅毒的几率很大(26.02%),且梅毒发作期患者比例高(20.33%)。结论需进一步加强对大型综合性医院就诊患者的HIV检测。性活跃期MSM(men who have sex with men)人群(尤其是双性性接触的MSM)需继续作为艾滋病防控宣传和咨询检测的重点人群,防止HIV感染由高危人群向一般人群传播。及时治疗梅毒感染,有效控制梅毒的发病率,对于控制艾滋病的流行有着重要意义。
Objective To analyze the epidemiological characteristics and syphilis infection of HIV patients in a general hospital in Beijing from 2012 to 2017, and to provide evidence for regional HIV screening and prevention.Methods Descriptive epidemiological analysis was carried out on the data of HIV-infected outpatients and inpatients in a general hospital in Beijing from 2012 to 2017.Results Totally 222550 people were screened for HIV in the hospital during the period of 2012 to 2017, 285(0.13%) were initially positive in anti-HIV antibody screening test and 246(0.11%) were confirmed positive in Western Blotting test. The positive rate of HIV infection in each year was relatively stable, and the rising trend was not obvious. The majority of HIV antibody positive patients were male(96.34%) to male-female ratio 26.33∶1, 20-39 years old(82.52%), and nonlocal census register(84.96%). Most patients were married(56.50%) and the proportion of HIV positive patientsthat married increased with time(P<0.05). The patients were all infected via sexual transmission, mainly homosexual transmission(96.34%). The visiting departments were mainly located in dermatology(43.50%), internal medicine(16.67%), surgery(13.41%) and physical examination centers(11.79%). Among the HIVpositive patients from the whole department of internal medicine,the department of gastroenterology accounted for 65.85%. The proportion of HIV/syphilis coinfection was high(26.02%) with high proportion of syphilis infection in attack stage(20.33%).Conclusion It is necessary to further strengthen the HIV detection in large general hospitals. MSM population in sexually active period(especially MSM with bisexual contact) should continue to be the focus of AIDS prevention and control propaganda and counseling and testing to prevent HIV infection from high-risk groups to the general population.Timely treatment of syphilis infection and effective control of the incidence of syphilis are of great significance in controlling the epidemic of AIDS.
Objective To analyze the epidemiological characteristics and syphilis infection of HIV patients in a general hospital in Beijing from 2012 to 2017, and to provide evidence for regional HIV screening and prevention.Methods Descriptive epidemiological analysis was carried out on the data of HIV-infected outpatients and inpatients in a general hospital in Beijing from 2012 to 2017.Results Totally 222550 people were screened for HIV in the hospital during the period of 2012 to 2017, 285(0.13%) were initially positive in anti-HIV antibody screening test and 246(0.11%) were confirmed positive in Western Blotting test. The positive rate of HIV infection in each year was relatively stable, and the rising trend was not obvious. The majority of HIV antibody positive patients were male(96.34%) to male-female ratio 26.33∶1, 20-39 years old(82.52%), and nonlocal census register(84.96%). Most patients were married(56.50%) and the proportion of HIV positive patientsthat married increased with time(P<0.05). The patients were all infected via sexual transmission, mainly homosexual transmission(96.34%). The visiting departments were mainly located in dermatology(43.50%), internal medicine(16.67%), surgery(13.41%) and physical examination centers(11.79%). Among the HIVpositive patients from the whole department of internal medicine,the department of gastroenterology accounted for 65.85%. The proportion of HIV/syphilis coinfection was high(26.02%) with high proportion of syphilis infection in attack stage(20.33%).Conclusion It is necessary to further strengthen the HIV detection in large general hospitals. MSM population in sexually active period(especially MSM with bisexual contact) should continue to be the focus of AIDS prevention and control propaganda and counseling and testing to prevent HIV infection from high-risk groups to the general population.Timely treatment of syphilis infection and effective control of the incidence of syphilis are of great significance in controlling the epidemic of AIDS.
引文
[1]苏德华,王大勇,赵丽娜,等.2005-2013年浙江省温州市艾滋病免费抗病毒治疗患者流行病学特征分析[J].疾病监测,2014,29(6):469-472.
[2]王万海,任春锋,梅园丁,等.某综合性医院2010~2012年住院患者HIV-1抗体初筛结果[J].中国热带医学,2013,13(6):687-689.
[3]郭燕,朱效科,夏建晖,等.204例MSM人群HIV/梅毒感染状况及行为学特征分析[J].中国艾滋病性病,2009,15(1):50-51,71.
[4]中国疾病预防控制中心.全国艾滋病检测技术规范[M].北京:中国疾病预防控制中心:2009.
[5]宋晓璟,邱志峰,曹玮,等.2003-2014年北京协和医院就诊患者HIV检测结果分析[J].中华流行病学杂志,2017,38(1):81-85.
[6]National Health and Family Planning Commission of the People′s Republic of China.2014 China AIDS Response progress report[DB/OL].Beijing:China,2014.[2016-07-01].http://www.unaids.org/sites/default/files/documents/CHN-narrative-report_2014.pdf.
[7]王桂英,刘康迈,李杰.艾滋病流行特点及潜在危险因素分析[J].中国健康教育,1998,14(11):4-5.
[8]陈强,李桂英,孙燕鸣,等.北京市2012年男男性行为者HIV及梅毒感染状况调查[J].中华皮肤科杂志,2014,47(5):349-350.
[9]徐成芬,吴晓.不同检验方法对梅毒不同时期的敏感性和特异性分析[J].中国性科学,2014,23(10):49-51.
[10]沈国强.3种方法在梅毒检测中的比较和运用[J].检验医学与临床,2013,10(3):358-359.
[11]王磊,李维云,吉彬,等.2007-2016年性病门诊中老年HIV与梅毒共感染现状分析[J].中国性科学,2017,26(12):64-67.
[12]田晓波,潘书娟,白晶,等.HIV合并梅毒感染的实验诊断分析[J].中国性科学,2016,25(12):73-75.
[13]CHANP A,ROSE J,MAHER J,et al.A latent class analysis of risk factors for acquiring HIV among men who have sex with men:Implications for implementing pre-exposure prophylaxis programs[J].AIDS Patient Care STDS,2015,29(11):597-605.
[14]KALICHMANS C,PELLOWSKI J,TURNER C.Prevalence of sexuallytransmitted co-infections in people living with HIV/AIDS:Systematic review with implications for using HIV treatments for prevention[J].Sex Transm Infect,2011,87(3):183-190.
[15]DEUFFIC-BURBAN S,DELAROCQUE-ASTAGNEAU E,ABITE-BOUL D,et al.Blood-borne viruses in health care workers:Prevention and management[J].J.Clin.Virol.,2011,52(1):4-10.
[2]王万海,任春锋,梅园丁,等.某综合性医院2010~2012年住院患者HIV-1抗体初筛结果[J].中国热带医学,2013,13(6):687-689.
[3]郭燕,朱效科,夏建晖,等.204例MSM人群HIV/梅毒感染状况及行为学特征分析[J].中国艾滋病性病,2009,15(1):50-51,71.
[4]中国疾病预防控制中心.全国艾滋病检测技术规范[M].北京:中国疾病预防控制中心:2009.
[5]宋晓璟,邱志峰,曹玮,等.2003-2014年北京协和医院就诊患者HIV检测结果分析[J].中华流行病学杂志,2017,38(1):81-85.
[6]National Health and Family Planning Commission of the People′s Republic of China.2014 China AIDS Response progress report[DB/OL].Beijing:China,2014.[2016-07-01].http://www.unaids.org/sites/default/files/documents/CHN-narrative-report_2014.pdf.
[7]王桂英,刘康迈,李杰.艾滋病流行特点及潜在危险因素分析[J].中国健康教育,1998,14(11):4-5.
[8]陈强,李桂英,孙燕鸣,等.北京市2012年男男性行为者HIV及梅毒感染状况调查[J].中华皮肤科杂志,2014,47(5):349-350.
[9]徐成芬,吴晓.不同检验方法对梅毒不同时期的敏感性和特异性分析[J].中国性科学,2014,23(10):49-51.
[10]沈国强.3种方法在梅毒检测中的比较和运用[J].检验医学与临床,2013,10(3):358-359.
[11]王磊,李维云,吉彬,等.2007-2016年性病门诊中老年HIV与梅毒共感染现状分析[J].中国性科学,2017,26(12):64-67.
[12]田晓波,潘书娟,白晶,等.HIV合并梅毒感染的实验诊断分析[J].中国性科学,2016,25(12):73-75.
[13]CHANP A,ROSE J,MAHER J,et al.A latent class analysis of risk factors for acquiring HIV among men who have sex with men:Implications for implementing pre-exposure prophylaxis programs[J].AIDS Patient Care STDS,2015,29(11):597-605.
[14]KALICHMANS C,PELLOWSKI J,TURNER C.Prevalence of sexuallytransmitted co-infections in people living with HIV/AIDS:Systematic review with implications for using HIV treatments for prevention[J].Sex Transm Infect,2011,87(3):183-190.
[15]DEUFFIC-BURBAN S,DELAROCQUE-ASTAGNEAU E,ABITE-BOUL D,et al.Blood-borne viruses in health care workers:Prevention and management[J].J.Clin.Virol.,2011,52(1):4-10.