1.Efficacy of antiviral therapy on prevention of HIV transmission among sero-discordant couples in Guangxi Zhuang autonomous region.
Qiuying ZHU ; Xiaoyi YANG ; He JIANG ; Guangjie TAN ; Runsong XIONG ; Lingjie LIAO ; Hui XING ; Yuhua RUAN ; Zhiyong SHEN ; Email: SHENZHIYONG99999@SINA.COM. ; Zhenzhu TANG ; Yiming SHAO ;
Chinese Journal of Epidemiology 2015;36(12):1401-1405
OBJECTIVETo understand the efficacy of antiviral therapy on prevention of HIV transmission and to assess the feasibility of treatment-as-prevention strategy in public health practice, among sero-discordant couples in Guangxi Zhuang autonomous region (Guangxi).
METHODSData was gathered through the AIDS prevention and control information system in Guangxi from January 1, 2008 to December 31, 2014, on HIV sero-discordant couples. Time-dependent Cox Model was used to analyze the efficacy of antiviral treatment.
RESULTSA total of 7 694 sero-discordant couples were followed and 394 appeared positive from those negative spouses. The overall HIV positive seroconversion rate was 2.5 (2.2-2.7) /100 person-year. The HIV positive sero-conversion rates were 4.3 (3.7-4.8) /100 person-year in the untreated cohort and 1.6 (1.4-1.9) per 100 person-year in the treated cohort. Rate of HIV transmission declined by 51% in the treated cohort (HR=0.49, 95%CI: 0.40-0.60) but appeared as 45% (AHR=0.55, 95%CI:0.43-0.69) after adjusting for factors as sex, age, education, marital status, occupation, transmission route and baseline CD4(+)T lymphocyte cell count. The rate of reduction in transmission was significant among couples in which the HIV-positive spouses showing the following features as: aged ≥25 years, married, farmers, with educational level of junior high school or below, baseline CD4(+)T lymphocyte cell count <500 cells/mm(3) and infection was through heterosexual intercourse.
CONCLUSIONAntiviral therapy as a prevention strategy among sero-discordant couples seemed feasible and effective in Guangxi. Expansion of the coverage on antiviral therapy would reduce the spread of HIV in married couples.
Adult ; Antiviral Agents ; therapeutic use ; CD4 Lymphocyte Count ; statistics & numerical data ; China ; Feasibility Studies ; HIV Infections ; prevention & control ; transmission ; HIV Seronegativity ; HIV Seropositivity ; Heterosexuality ; Humans ; Socioeconomic Factors ; Spouses ; statistics & numerical data ; Treatment Outcome
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