LAg-avidity EIA技术在湖北省艾滋病哨点监测重点人群新发感染率估算中的应用

Application of LAg-avidity EIA in the estimate of HIV-1 incidence among key surveillance populations in Hubei Province

摘要:

目的 应用LAg-avidity EIA技术对湖北省艾滋病哨点监测阳性样本开展新发感染检测，了解2017-2020年湖北省哨点监测男男性行为者、吸毒者、女性性工作者和性病门诊男性就诊者的HIV新发感染情况。方法 收集2017-2020年湖北省国家HIV 监测哨点中四类重点人群的HIV-1抗体阳性样本，使用限制性抗原亲和力酶免疫试验开展新发感染检测，估算各人群年度新发感染率。结果：男男性行为人群感染率最高，其2017-2020年的感染率分别为2.90%、4.48%、3.63和2.78%，晚发现比例由2017年的16.67%上升至2020年的28.81%，其新发感染率分别为1.64%（0.85%～2.44%）、1.41%（0.59%~2.23%）、1.46%（0.71%~2.21%）和0.96%（0.34%~1.57%），新发感染率的差异无统计学意义(c2= 1.491，P=0.684) 。性病门诊男性就诊者2017-2020年感染率分别为0. 03%、0. 01%、0.06%和0. 08%，其新发感染率分别为0.09%（-0.06%~0.25%）、0.10（-0.06%~0.26%）、0.26%（0.02%~0.50%）和0.04%（-0.07%~0.15%）。女性性工作者的阳性率和新发感染率处于较低水平，吸毒者人群的感染率略有波动，但均未检测出新发感染的病例。结论 2017-2020湖北省男男性行为人群的新发感染率相对于其它几类重点人群较高，但整体呈下降趋势，提示应继续加强男男性行为人群的干预力度，扩大重点人群检测覆盖面。

Abstract:

Objective Limiting antigen avidity enzyme immunoassay (LAg-Avidity EIA) was applied to calculate the HIV-1 incidence of new HIV infections among men who have sex with men(MSM), drug users(DUS), female sex workers(FSW) and male patients in sexually transmitted diseases clinics(STD) in 2017-2020 of Hubei. Methods HIV-1 antibody positive samples were collected from four key groups in the national HIV sentinel surveillance from 2017 to 2020, and tested by the LAg-Avidity EIA to estimate the annual new infection rate of each group. Results The prevalence of MSM was 2.90%, 4.48%, 3.63 and 2.78% from 2017-2020, respectively, which was the highest among the four groups. The rate of late diagnosis increased from 16.67% in 2017 to 28.81% in 2020.The incidence of MSM was 1.64%(0.85%-2.44%),1.41%(0.59%-2.23%),1.46% (0.71%-2.21%) and 0.96%(0.34%-1.57%), respectively, and the difference was not statistically significant (χ2=1.491, P=0.684). The prevalence of STD from 2017-2020 was 0.03%, 0.01%, 0.06% and 0.08%, respectively, with the incidence was 0.09% (-0.06%-0.25%), 0.10(-0.06%-0.26%), 0.26% (0.02%-0.50%) and 0.04%(-0.07%-0.15%). The prevalence and incidence among FSW remains very low, while the prevalence of DUS fluctuated slightly, but no new infections have been detected. Conclusion The incidence of new HIV infection among MSM in Hubei province from 2017-2020 is relatively high compared with other key groups, but the overall trend is declining, thus the intervention of MSM should be further strengthened and expand the coverage of testing in key populations.