2003-2014年北京协和医院就诊患者HIV检测结果分析

摘要

目的 了解2003-2014年北京协和医院就诊患者HIV检测的感染状况及流行病学特征.方法 收集2003-2014年北京协和医院门诊与住院就诊患者的HIV检测结果,利用SPSS19.0软件进行描述性统计分析.结果 2003-2014年共进行HIV筛查715 421人次,HIV初筛阳性1 012例(0.14％),HIV确证阳性776例(0.11％).HIV检测阳性率逐年升高(趋势x2=66.83,P=0.000),2012-2014年间增幅明显,2014年的HIV检测阳性率是2003年的3.40倍(2014年为0.17％,2003年为0.05％).776例感染者中,男性631例(81.31％),女性145例(18.69％),2003-2014年间男性感染者构成比从50.00％升高到90.26％(趋势x2=58.41,P=0.000),年龄范围18～50岁(84.66％),M为36岁(QR:27 ～ 43).经性途径感染634例(81.70％),且逐年增加(趋势x2=126.38,P=0.000),男男同性性行为感染从2003年的0.00％升高到2014年的53.90％(趋势x2=11.96,P=0.001).未婚感染者构成比从18.75％升高到42.21％(趋势x2=43.74,P=0.000).HIV筛查阳性的主要来源科室分别为内科(51.03％)、急诊(18.30％)、皮肤科(13.53％).妇产科来源下降(2003年为18.75％,2014年为2.60％),外科、五官科及口腔科、体检中心有所增加,分别从2003年的零检出到2014年的14例(9.10％),11例(7.14％),4例(2.60％).结论 北京协和医院就诊患者的HIV/AIDS检测阳性率逐年升高,提示需要加强对大型综合医院就诊患者的检测.MSM作为重点人群,应加强艾滋病防控宣传和咨询检测.%Objective To better understand the infection status of HIV in the patients seeking medical care in Peking Union Medical College Hospital.Methods The HIV detection data of the patients in the hospital from 2003-2014 were collected for a statistical analysis with software SPSS 19.0.Results A total of 715 421 patients were screened,and 1 012 (0.14％) patients were HIV positive,and HIV infection were confirmed in 776 (0.11％) patients by Western Blot testing.The detection rate of HIV infection increased from 0.05％ in 2003 to 0.17％ in 2014 (trend x2=66.83,P=0.000),and the increase during 2012-2014 was obvious.Of the 776 newly diagnosed HIV-infected individuals,631 (81.31％) were men and 145 (18.69％) were women.The percentage of the males infected with HIV increased from 50.00％ to 90.26％ (trend x2=58.41,P=0.000).The median age was 36 years (interquartile range:27-43),and the age group 18-50 years were mostly affected.In the 776 patients infected with HIV,634 (81.70％) were infected through sexual contacts,and the proportion of sexual transmissions increased with year (trend x2=126.38,P=0.000).The proportion of infected men who have sex with men (MSM) increased from 0％ in 2003 to 53.90％ in 2014 (trend X2=11.96,P=0.001),similar to the trend in western countries.The proportion of infected patients who were not married increased from 18.75％ to 42.21％ (trend x2=43.74,P=0.000).The top three source departments of HIV/AIDS cases were internal medicine (51.03％),emergency room (18.30％) and dermatology (13.53％).The proportion of the HIV/AIDS patients from department of gynecology and obstetrics declined from 18.75％ in 2003 to 2.60％ in 2014.No HIV/AIDS patients were detected in department of surgery,department of otorhinolaryngology,department of ophthalmology,department of stomatology and health examination center in 2003,but 14 cases (9.10％),11 cases (7.14％) and 4 cases (2.60％) were detected in these departments respectively in 2014.Conclusion The HIV detection rate increased with year in Peking Union Medical College Hospital,suggesting the necessity of strengthened HIV test in general hospitals.MSM are the population at high risk,to whom more attention should be paid.