金沙萨感染人类免疫缺陷病毒的不和谐夫妇的概况:以Monkole医疗中心为例

Isaac T. Woto, Cagod B. Inkale, Simplice K. Makoka, Samclide Mbikayi, Berry I. Bongenya, Erick N. Kamangu
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引用次数: 0

摘要

背景:在非洲,针对血清不一致夫妇的规划并不是预防人类免疫缺陷病毒(HIV)感染的重点,尽管其中很大一部分发生在稳定的关系中,其中血清不一致约占三分之二,血清阴性伴侣的血清转化风险很高。目的:本研究的目的是描述在刚果民主共和国金沙萨随访的HIV血清不一致夫妇的概况。方法:描述性横断面研究,描述2021年11月至2022年6月在刚果民主共和国金沙萨Monkole医疗中心随访的不同异性恋HIV血清不一致夫妇的概况。数据收集自研究小组编写的信息表,以及蒙科尔医疗中心传染病科管理的患者的计算机档案在知情同意书签署后提供的信息。取患者前臂外周静脉平均8cc血样,在- 20˚C条件下保存于EDTA管中,其中至少6ml用于生化分析,每对伴侣2点200 μL血样在- 20˚C条件下保存于滤纸上,用于DNA提取。巢式PCR证实血清学诊断。结果:在Monkole医学中心对482对异性恋夫妇进行了HIV跟踪调查,其中28对(5.8%)HIV血清检测结果不一致,其中14对(2.9%)同意参加本研究。平均年龄43.39±10岁,极值24 ~ 62岁。患者主要来自非正规部门(53.6%),体重在61 ~ 71 kg之间(46.4%)。所有夫妇继续性交,有生育欲望(82.1%)未使用安全套(85.7%);尽管绝大多数艾滋病毒阴性伴侣(85.7%)没有接受抗逆转录病毒药物预防。在42.9%的hiv阴性伴侣中发现白细胞减少,而在21%的hiv阳性伴侣中发现白细胞减少;所有的伴侣都有主要的淋巴细胞白细胞计数。21.4%的hiv阴性伴侣有高HDL, 14.3%的hiv阳性伴侣有低HDL, 14.3%的hiv阴性伴侣有高LDL。卡方检验和皮尔逊相关检验显示,所测生化参数与夫妇的HIV血清不一致之间没有关系。结论:金沙萨地区HIV不和谐夫妻发生率较高。在渴望生育的年轻知识分子和企业家夫妇中会遇到血清失调。为了更好地管理这些夫妇,需要进行进一步的分析。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Profile of Discordant Couples for Human Immunodeficiency Virus Infection Followed in Kinshasa: Case of Monkole Medical Center
Background: Programs targeting serodiscordant couples in Africa are not a priority in efforts to prevent Human Immunodeficiency Virus (HIV) infection, although a large proportion of these occur in stable relationships, of which serodiscordance accounts for about two-thirds with a high risk of seroconversion of the seronegative partner. Objective: The objective of this study was to describe the profile of HIV serodiscordant couples followed in Kinshasa, DRC. Methods: Descriptive cross-sectional study to describe the profile of different heterosexual HIV serodiscordant couples followed at the Monkole Medical Center in Kinshasa, DRC, from November 2021 to June 2022. The data were collected from the information sheets elaborated by the research team as well as from the information provided by the computerized files of the patients managed at the Infectious Diseases Unit of the Monkole Medical Center after the signature of the informed consent. An average of 8 cc of blood was taken from a peripheral vein in the patient’s forearm, and was stored in EDTA tubes at −20˚C, of which at least 6 mL were used for biochemical analyses, 2 spots of 200 μL for each partner were stored on filter paper at −20˚C and were used for DNA extraction. Nested PCR confirmed the serological diagnosis. Results: Out of a total of 482 heterosexual couples followed for HIV at the Monkole Medical Center, 28 (5.8%) were HIV serodiscordant, of which 14 (2.9%) couples agreed to participate in the present study. The mean age was 43.39 ± 10 years with extremes ranging from 24 to 62 years. The patients were mainly from the informal sector (53.6%) and weighed between 61 and 71 kg (46.4%). Sexual intercourse continued in all couples, without condom use (85.7%) for desire of procreation (82.1%); although the great majority of HIV-negative partners (85.7%) were not under ARV prophylaxis. Leukopenia was found in 42.9% of HIV-negative partners compared to 21% of HIV-positive partners; all partners had a predominantly lymphocytic white blood cell count. 21.4% of HIV-negative partners had high HDL, 14.3% of HIV-positive partners had low HDL, and 14.3% of HIV-negative partners had high LDL. Chi-square and Pearson correlation tests showed no relationship between the biochemical parameters performed and the couples’ serodiscordance for HIV. Conclusion: The frequency of HIV discordant couples in Kinshasa is significant. Serodiscordance is encountered in young intellectual and entrepreneurial couples with a desire to procreate. It is desirable to carry out further analyses for better management of these couples.
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