| Background: The number of HIV infected persons of our country is 8.4 million as end of 2004. Epidemic of HIV becomes more and more serious in our country. There are three reasons that lead to high epidemic of HIV in our country. 1.In the later 1990s, many people were infected HIV for transfusion in the middle rural area in our country. 2.More and more women who can not find job trade sex for money. 3.The number of intravenous drug users who share needles increase. To make things worse, commercial blood donors, drug users and sex workers bring virus home. we carry out a survey in Henan and Hubei provinces to analyze the intra-familial transmission of HIV.Objective: To investigate the intra-familial transmission of human immunodeficiency virus (HIV). To estimate HIV transmission rate of HIV from mother to children and HIV transmission between married spouses. To analyze factors that affect HIV- transmission.Methods: 305 families selected from a highly epidemic area of AIDS were interviewed for intra-familial transmission of human immunodeficiency virus (HIV). Blood samples were taken for anti-HIV mark tests from January 2002 to 2004. HIV-DNA or HIV-RNA were purified by PCR. Part of patients were tested for CD4~+T cell counts.Results: Intra-familial transmission of human immunodeficiency virus (HIV) were found to be in existence in 95 families among the 305 investigated families. Intra-familial transmission rate was 31.1%. No transmission was found in the rest 210 families, which accounts for 68.9% of the investigated families. Transmission between spouses and transmission from mother to child constitute 42.1% and 54.7% respectively in the transmitted families.3.2% (3/95) of the transmitted families were found to be in existence of transmission both from mother to child and between spouses. Transmission rate between spouses was 16.3% in those who acquired HIV virus through blood transfusion, which was lower than those who got the virus through sex. (62%). The transmission rate from husband to wife (24.4%) was not significantly different from that of wife to husband (18.3%), P>0.05. The HIV transmission rate between spouses with AIDS (38.6%) was significantly higher than that of HIV-carrier (11.9%), P<0.05. Transmission rate of old couples (≥50 years)was relatively higher than that of younger couples (<50 years).158 children born to 126 HIV infected mother were included in our study.61 children were found to be HIV positive. Mother to child transmission rate was 38.6%. 9 children who were born to 11 HIV positive mother by post partum transfusion were all breast-feed, children were positive, MTCT rate was 44.4% (4/9) by breasting. DNA fragment of HIV-1 gag gene PI7 were amplified by PCR from uncultured blood mononuclear cells (PBMCs) obtained from HIV-1 sero-positive high-risk women of children bearing age. Sequence analyses showed that all of them were HIV-1 B' subtype. The HIV vertical transmission rate among mother with AIDS (64.9%) was significantly higher than that of HIV-carrier (24.7%), P<0.05. Among 75 children infected HIV, 61 cases were due to mother-to- child transmission (81.3%, 61/75), 11 cases were infected by blood transmission (14.7%, 11/75).We can not determine the transmission of 3 HIV infected children.Higher CD4+T counts were found to be associated with lower transmission rate.No transmission was found from father to child and between siblings. HIV transmission through daily contact within family will be not common.Conclusion: Intra-familial transmission rate of HIV was 33.1%. Transmission rate between transfusion associated couple and sex-acquired spouse were 16.3%, and 62%. Old couples(^50) were found to have higher transmission rate. Mother-to-child transmission rate was 38.6%. Patients in AIDS status have higher transmission rate than that of HIV-carrier. Higher CD4+T counts were associated with lower transmission rate.
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