【摘要】：目的應(yīng)用BED捕獲酶免疫實(shí)驗(yàn)（BED capture enzyme immunoassay, BED-CEIA）的檢測(cè)方法對(duì)HIV-1感染者進(jìn)行新發(fā)感染檢測(cè)，并對(duì)安徽省HIV-1新發(fā)感染者情況及患者特征進(jìn)行分析，從而來確定各種特征和因素與新發(fā)感染的相關(guān)性。 方法收集2011年7月至2012年6月安徽省全省各艾滋病確證實(shí)驗(yàn)室新確證HIV-1型感染者血清/血漿，進(jìn)行BED-CEIA檢測(cè)；再通過對(duì)艾滋病綜合防治信息系統(tǒng)中各級(jí)疾病預(yù)防控制機(jī)構(gòu)對(duì)艾滋病病毒感染者進(jìn)行的個(gè)案流行病學(xué)資料進(jìn)行分析，，評(píng)估新發(fā)感染情況并分析其患者特征；同時(shí)對(duì)2011年和2012年安徽省男男性行為者（Men who have sex with men, MSM）哨點(diǎn)初篩陽性樣本，進(jìn)行HIV確證實(shí)驗(yàn)，確證陽性樣本再進(jìn)行新發(fā)感染檢測(cè)，以此來估算出此類高危人群的新發(fā)感染率。 結(jié)果2011年7月至2012年6月安徽省新報(bào)告HIV感染者748例，通過BED-CEIA方法檢測(cè)出184例為新近感染，HIV-1感染者新發(fā)感染比例為24.6%；通過對(duì)新近感染者與既往感染者特征的比較，新發(fā)感染者中，男性、農(nóng)民、MSM以及醫(yī)院就診者比例較高。與既往感染患者相比，新近感染者年齡更輕，且男性所占比例以及男男同性性行為者的比例均較高，并伴有更高的CD4細(xì)胞數(shù)，而農(nóng)民在新近感染者中的比例有所降低；對(duì)2011和2012年安徽省MSM哨點(diǎn)初篩陽性樣本進(jìn)行蛋白印跡法（Western blot, WB）確證實(shí)驗(yàn)，分別檢測(cè)出新發(fā)感染例數(shù)為8例和18例，再采用Hargrove法中點(diǎn)公式計(jì)算MSM人群新發(fā)感染率分別為5.53%和3.95%。結(jié)論通過BED檢測(cè)方法估算出安徽省2011-2012年HIV-1新報(bào)告感染者新發(fā)感染比例較高，再通過對(duì)高危人群的分析發(fā)現(xiàn)男男同性性行為是新發(fā)感染的主要風(fēng)險(xiǎn)因素，且MSM哨點(diǎn)新發(fā)感染率較高與病例報(bào)告的新發(fā)感染中男男同性傳播因素高度相關(guān)情況相吻合，為科學(xué)的評(píng)估艾滋病流行趨勢(shì)、確定監(jiān)測(cè)方案和針對(duì)高危人群制定合理的防控措施提供更多的依據(jù)。
[Abstract]:Objective to detect the new infection of HIV-1 infected by BED capture enzyme immunoassay (BED capture enzyme immunoassay, BED-CEIA), and to analyze the status and characteristics of HIV-1 infection in Anhui province. To determine the characteristics and factors associated with new infections. Methods from July 2011 to June 2012, the serum / plasma of newly confirmed HIV-1 patients in Anhui Province were collected and tested for BED-CEIA. Then through the analysis of the case epidemiological data of HIV infection by the disease prevention and control agencies at all levels in the comprehensive AIDS prevention and control information system, the new infection situation and the characteristics of the patients were evaluated. At the same time, the positive samples of (Men who have sex with men, MSM) sentinel spot in Anhui Province in 2011 and 2012 were tested by HIV confirmatory test, and the positive samples were tested for new infection. This is used to estimate the incidence of new infections in such high-risk groups. Results from July 2011 to June 2012, 748 new cases of HIV infection were reported in Anhui province. 184 cases were newly infected by BED-CEIA, and the rate of new infection of HIV-1 infection was 24.6; By comparing the characteristics of newly infected persons with those of previous infections, the proportion of newly infected men, farmers, MSM and hospital patients was higher. Compared with the patients with previous infection, the newly infected patients were younger, the proportion of men and men who had sex with men were higher and the number of CD4 cells was higher, but the proportion of farmers in newly infected patients was lower. The positive samples of MSM sentinel screening in Anhui Province in 2011 and 2012 were confirmed by Western blot (Western blot, WB). The number of new infections was 8 cases and 18 cases, respectively. The new infection rate of MSM was 5.53% and 3.95% respectively by using the midpoint formula of Hargrove method. Conclusion it is estimated by BED test that the proportion of newly reported new infections of HIV-1 in Anhui Province from 2011 to 2012 is high, and the analysis of high risk population shows that male homosexual sex is the main risk factor of new infection. Moreover, the high rate of new infection in MSM sentinel site coincided with the high correlation between male and male homosexual transmission factors in the newly reported cases, which is a scientific assessment of the trend of AIDS epidemic. To determine the monitoring program and to establish reasonable prevention and control measures for high-risk groups to provide more basis.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R512.91

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