未知情家庭艾滋病传播回顾性定群研究
Retrospective cohort study on HIV-1 intrafamilial transmission infector
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摘要: 目的 研究在未知情的情况下,家庭内艾滋病病毒的传播率及影响因素.方法 选择某地1995年前后家庭成员因受血感染人类免疫缺陷病毒1型 (HIV-1)的117个家庭,平均8年后观察其他家庭成员HIV感染状况.结果 在117个家庭中,有39个家庭发生了家庭传播,家庭传播率为33.3%;存在传播危险因素的家庭成员感染率为22.8% (49/215),不存在传播危险因素的家庭成员中未发现感染者.家庭内夫妻传播和母婴传播危险因素并存导致家庭传播率高达47.8% (32/67),存在母婴传播因素的家庭传播率为40.9% (27/66),存在夫妻传播因素的家庭传播率为16.5% (19/115),妻子作为家庭引入病例导致38.5% (37/96)的家庭传播率,丈夫作为家庭引入病例的家庭传播率为9.5% (2/21);妻子感染时的年龄越小,家庭传播率越高;夫妻传播危险因素存续时间越长,家庭夫妻传播率越高;母婴传播危险因素存续时间长短不影响家庭母婴传播率.结论 通过回顾性队列研究,获得了家庭成员未知情条件下的家庭传播率和家庭成员传播率.Abstract: Objective To study the transmission rate and influence factors of human immunodeficiency virus type 1 (HIV-1) among the family members with unknown infector.Methods An average 8 years retrospective follow-up was conducted among 487 persons in 117 families with HIV-1 infected members.Results Among 117 families,39 persons were infected with HIV-1,the intrafamilial transmission rate was 33.3%.The HIV-1 infection rate was 22.8% (49/215) for family members with transmission factors,and no family member without transmission factors was found to be infected by HIV.Both the spousal transmission and mother-to-child transmission (MTCT) resulted in higher intrafamilial transmission rate (47.8% 32/67 for familial transmission,40.9% 27/66 for MTCT,and 16.5% 19/115 for spousal transmission).Intrafamilial transmission rates of HIV by wife and husband carriers were 38.5% (37/96) and 9.5% (2/21),respectively.The intrafamilial transmission rate was higher in familes with younger wife infector and long time existense of spousal transmission risk factor.The MTCT was not influenced by the time of MTCT factor existence.Conclusion The intrafamilial transmission rate of HIV-1 was obtained for families with unrecognized infector.
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