Cohort Study On HIV Household Transmission In Three High Prevalence Villages In Henan Province

Currently,Acquired immunodeficiency syndrome(AIDS) is a chronic communicable disease with high fatality rate which can not be cured.Widely spread of AIDS also resulted in serious public sanitation and social problems among the world.HIV/AIDS prevalence in Henan province is mainly caused by former irregularly blood/plasma donation during mid 1990s and farmers were suffering severely.Now,HIV infection via blood donation has been interdicted and HIV epidemic status in Henan province is relatively clear,HIV/AIDS patients have been cared routinely.Comprehensive epidemiological study of AIDS prevalence in former plasma donors (FPD) is helpful to find out the characteristics of AIDS incidence,mortality and its influence factors,thus providing evidences for planning of AIDS control strategies and measures.Objectives To study character of HIV infection via sexual route between discordant couples and mother-to-child transmission,natural history of HIV infection in FPDs live in 3 villages in Henan province,exploring character of HIV family transmission and its influence factors in FPDs,evaluating effects of interventions,controlling measures and HAART,providing evidences for developing AIDS control strategies and measures.Methods Three villages in Henan province where most FPDs lived during mid 1990s("AIDS epidemic village" below) were selected as study site.Ambispective cohort study is used to explore HIV transmission character.All data collected were entered into a computer-based database.HIV natural history was studied using epidemiological data.Baseline investigation data and follow-up data were collected and entered into a database developed using Visual Foxpro 9.0 and statistical analyzed using SPSS 10.0.Results After following for 12 years,HIV infection rate in HIV discordant couples is 6.13% (13 persons/212 couples) and infection rate in negative couples is 0.44%(3 persons/681 couples), deference between two groups is statistically significant(x2 = 26.62,＜0.01).In exposure group,rate of HIV transmitted by husband to wife in couples which husband is HIV positive and wife is negative is 5.82%(11/189) after 12 years;and rate of HIV transmitted by wife to husband in couples which wife is HIV positive and husband is negative is 6.83%(11/161) after 12 years.Deference between two groups is non-significant(x2= 0.01,P＞0.05).For mother-to-child transmission cohorts,HIV transmission rate in exposure group(mother is tested positive) is 10.81%(20/185) after 12 years and that in non-exposure group is 0.43% (3/696),deference between two groups is statistically significant(x2=57.92,P＜0.01).HIV infection probability of children bom by mother who is test positive is more than those gave birth by mother who is test negative.The average latent period of HIV in FPDs is 3049 days(8.35 years),and average survival period of AIDS is 601 days(20.3 months).There were 557 HIV/AIDS patients alive on the day Mar.1^st 2008,and their survival period after infected HIV is 4693 days(12.85 years).92.17%(577 of 626) HIV infection patients in 3 villages have developed into AIDS.Age of 577 AIDS patients vary from 5 to 66 years,and average age is 39.30 years(SD=9.58 years).87 AIDS patients died during study and their age vary from 8 to 64 years.In the three villages,AIDS fatality rate is 13.90%(87/626) and natural death rate of HIV negative villagers is 3.69%(178/4821),rate deference between two groups is statistically significant(x2=124.68, P＜0.01).Conclusion In former plasma donation villages,HIV infection between discordant couples via sexual route in relative low and slow,HIV infection though sexual behavior can not result in widely epidemic in local area.HIV infection rate via PMTC is still at low level.Period from HIV to AIDS and HIV/AIDS survival period is relative long.All of these are contributed to the condom using,PMTC and HAART ect.in Henan province.Our study shows that both the transmission rate from husband to wife and from wife to husband are significantly higer than previous results reported from other literatures.HIV transmission interruption should be reinforced among single-HIV infected family in Henan.As Henan has a large and concentrated population of HIV infection,HIV transmission in family needs further control to prevent the virus transmitting from specific group to general.