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目的了解性病门诊生殖器溃疡性疾病(GUD)的HIV感染状况及其与HIV感染的关系。方法取GUD患者溃疡处分泌物进行暗视野显微镜检查、多重聚合酶链反应,同时取上述患者和非溃疡性性传播疾病(STD)患者尿道或宫颈或阴道分泌物进行淋球菌、沙眼衣原体、支原体、单纯疱疹病毒、人类乳头瘤病毒、念珠菌、滴虫及加特纳菌等检测;检测所有STD患者血清的HIV抗体及梅毒血清学试验。结果在8 962 例病人中,就诊时生殖器有溃疡的STD与生殖器无溃疡的STD病人中HIV 感染率分别为1.75% (5/285)和 1.53% (133/8677),两者无统计学意义(χ2=0.09, P>0.05; OR=1.15, 95% CI=0.47-2.81);梅毒、生殖器疱疹和其他STD病人的HIV感染率分别为2.81%(22/784)、0.74%(6/814)和1.49%(110/7 364),梅毒病人的 HIV 感染率明显高于生殖器疱疹和其他 STD 病人的 HIV 感染率,有统计学意义(2.81% vs 0.74%,χ2=9.92, P<0.005, OR=3.89, 95%CI=1.67-9.05; 2.81% vs 1.49%,χ2=7.66, P<0.001, OR=1.90, 95%CI=1.21-3.00)。结论本研究提示本组 GUD 病人 HIV 感染率较国外低,梅毒与 HIV 感染有明显相关性;生殖器疱疹病人与HIV 感染的关系尚待进一步研究。
Objective To understand the prevalence of HIV infection in genital ulcerative disease (GUD) in STD clinics and its relationship with HIV infection. Methods The secretions from the ulcer in GUD patients were examined by dark field microscopy and multiplex polymerase chain reaction. The urethral or cervical or vaginal secretions from patients and non-ulcerative sexually transmitted diseases (STD) were collected for Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma , Herpes simplex virus, human papillomavirus, Candida, Trichomonas and Gardnerella; Detecting serum HIV antibody and syphilis serology in all STD patients. Results Among 8 962 patients, the prevalence of HIV infection was 1.75% (5/285) and 1.53% (133/8677) in patients with genital ulcer STD and genital ulcer-free STD respectively, both of which were not statistically significant (χ2 = 0.09, P> 0.05; OR = 1.15, 95% CI = 0.47-2.81). The rates of HIV infection in syphilis, genital herpes and other STD patients were 2.81% (22/784) and 0.74% ) And 1.49% (110/7 364) respectively. The prevalence of HIV infection in syphilis patients was significantly higher than that in genital herpes and other STD patients (2.81% vs 0.74%, χ2 = 9.92, P <0.005, OR = 3.89, 95% CI = 1.67-9.05; 2.81% vs 1.49%, χ2 = 7.66, P <0.001, OR = 1.90, 95% CI = 1.21-3.00). Conclusions This study suggests that the HIV prevalence rate of GUD patients in this group is lower than that of other countries and there is a significant correlation between syphilis and HIV infection. The relationship between genital herpes patients and HIV infection remains to be further studied.