中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2011年
12期
1227-1231
,共5页
段松%杨跃诚%韩晶%杨顺生%杨盈波%龙玉存%李国强%尹锦松%项丽芬%叶润华%高洁%唐仁海%庞琳%柔克明%吴尊友%何纳
段鬆%楊躍誠%韓晶%楊順生%楊盈波%龍玉存%李國彊%尹錦鬆%項麗芬%葉潤華%高潔%唐仁海%龐琳%柔剋明%吳尊友%何納
단송%양약성%한정%양순생%양영파%룡옥존%리국강%윤금송%항려분%협윤화%고길%당인해%방림%유극명%오존우%하납
美沙酮维持治疗%艾滋病病毒%新发感染率%队列研究
美沙酮維持治療%艾滋病病毒%新髮感染率%隊列研究
미사동유지치료%애자병병독%신발감염솔%대렬연구
Methadone maintenance treatment%Human immunodeficiency virus%Incidence%Cohort study
目的 了解云南省德宏州美沙酮维持治疗(MMT)就诊者中HIV新发感染率及其危险因素.方法 将德宏州2005年6月至2011年6月间所有入组MMT且HIV检测阴性的海洛因成瘾者作为研究对象纳入队列观察其HIV阳转情况,计算HIV新发感染率并运用Cox比例风险回归模型分析其影响因素.结果 共有3154名对象符合队列纳入标准,截至2011年6月,共有1023人(32.4％)入组MMT后从未接受过HIV随访检测,属于“失访”；另有2131人(67.6％)接受过至少一次HIV随访检测,累计随访观察4615.86人年,期间22人发生HIV抗体阳转,HIV新发感染率为0.48/100人年.无业、无婚史、自认入组前有注射毒品史者以及入组时HCV检测阳性者的HIV新发感染率较高,随访期间尿检结果均为阴性者中无一例HIV新发感染.运用Cox比例风险模型多因素分析显示,在控制混杂因素的影响后,入组前无注射毒品史者的HIV感染风险显著低于入组前有注射毒品史者(HR=0.29,95％CI:0.11～ 0.76).结论 德宏州MMT在减少HIV经吸毒途径传播中初显成效,需重点关注入组MMT前有静脉注射毒品行为以及治疗期间偷吸海洛因的MMT就诊者中HIV新发感染,加强随访和HIV检测力度.
目的 瞭解雲南省德宏州美沙酮維持治療(MMT)就診者中HIV新髮感染率及其危險因素.方法 將德宏州2005年6月至2011年6月間所有入組MMT且HIV檢測陰性的海洛因成癮者作為研究對象納入隊列觀察其HIV暘轉情況,計算HIV新髮感染率併運用Cox比例風險迴歸模型分析其影響因素.結果 共有3154名對象符閤隊列納入標準,截至2011年6月,共有1023人(32.4％)入組MMT後從未接受過HIV隨訪檢測,屬于“失訪”；另有2131人(67.6％)接受過至少一次HIV隨訪檢測,纍計隨訪觀察4615.86人年,期間22人髮生HIV抗體暘轉,HIV新髮感染率為0.48/100人年.無業、無婚史、自認入組前有註射毒品史者以及入組時HCV檢測暘性者的HIV新髮感染率較高,隨訪期間尿檢結果均為陰性者中無一例HIV新髮感染.運用Cox比例風險模型多因素分析顯示,在控製混雜因素的影響後,入組前無註射毒品史者的HIV感染風險顯著低于入組前有註射毒品史者(HR=0.29,95％CI:0.11～ 0.76).結論 德宏州MMT在減少HIV經吸毒途徑傳播中初顯成效,需重點關註入組MMT前有靜脈註射毒品行為以及治療期間偷吸海洛因的MMT就診者中HIV新髮感染,加彊隨訪和HIV檢測力度.
목적 료해운남성덕굉주미사동유지치료(MMT)취진자중HIV신발감염솔급기위험인소.방법 장덕굉주2005년6월지2011년6월간소유입조MMT차HIV검측음성적해락인성은자작위연구대상납입대렬관찰기HIV양전정황,계산HIV신발감염솔병운용Cox비례풍험회귀모형분석기영향인소.결과 공유3154명대상부합대렬납입표준,절지2011년6월,공유1023인(32.4％)입조MMT후종미접수과HIV수방검측,속우“실방”；령유2131인(67.6％)접수과지소일차HIV수방검측,루계수방관찰4615.86인년,기간22인발생HIV항체양전,HIV신발감염솔위0.48/100인년.무업、무혼사、자인입조전유주사독품사자이급입조시HCV검측양성자적HIV신발감염솔교고,수방기간뇨검결과균위음성자중무일례HIV신발감염.운용Cox비례풍험모형다인소분석현시,재공제혼잡인소적영향후,입조전무주사독품사자적HIV감염풍험현저저우입조전유주사독품사자(HR=0.29,95％CI:0.11～ 0.76).결론 덕굉주MMT재감소HIV경흡독도경전파중초현성효,수중점관주입조MMT전유정맥주사독품행위이급치료기간투흡해락인적MMT취진자중HIV신발감염,가강수방화HIV검측력도.
Objective To determine the incidence and risk factors of HIV infection among heroin addicts receiving methadone maintenance treatment(MMT)in Dehong prefecture,Yunnan province.Methods All heroin addicts who were HIV negative at the initiation of MMT in June 2005 and through June 2011,in Dehong prefecture were included in the cohort analysis.HIV incidence was calculated and related risk factors determined by using Cox proportional hazard regression model.Results A total of 3154 MMT clinic attendants were qualified for this cohort study.By June 2011,1023(32.4％)of them had never received any follow-up HIV testing so were thus referred as loss to follow-up.The other 2131(67.6％)members had received at least one follow-up HIV testing and were observed for a total of 4615.86 person-years.During the period,22 new HIV infections or seroconverters were identified,making the overall HIV incidence as 0.48/100 person-years.The HIV incidence was higher among those who were unemployed,never married,self-reported being injecting drug users(IDUs)and HCV positive at entry into the MMT program.None of those who were always negative on follow-up-urine-testing of morphine was discovered as HIV newly infected during the follow-up period.Data from multiple regression analysis under Cox proportional hazard model indicated that after controlling for confounding variables,non-IDUs at the entry point for the MMT program,were less likely to be HIV newly-infected or seroconverted than IDUs(HR=0.29,95％CI:0.11-0.76).Conclusion MMT prograqm in Dehong prefecture was demonstrated to be fairly effective in reducing HIV transmission through drug use.Those HIV negative attendants at the MMT clinic who were IDUs or keep using drugs during the treatment,were at higher risk of HIV seroconvertion.More efforts were needed to improve the follow-up and HIV testing programs for the MMT clinic attendants.
