| Background:In recent years,China's HIV epidemic pattern has undergone significant changes.Sexual transmission has become the main route of HIV transmission in China.Paying attention to sexual infections in single-yang families has become an important part of China's overall control of HIV/AIDS.As of July 31,2018,China's statistics show that there are 831 225 surviving HIV/AIDS patients,including 255,995 deaths.There are 486,890 HIV-infected patients and 344,335 AIDS patients.In 2017,134,512 HIV-infected/AIDS patients were newly discovered,and 18,231 HIV-infected patients were converted into AIDS patients in the same year,Of the 30,718 deaths reported in 2017,26,787 were fatal in the past and 3,931 were died.Among the newly discovered HIV/AIDS patients in 2017,the ratio of male to female HIV infection was 3.4:1,and the ratio of male to female AIDS was 4.0:1.In many countries and regions,heterosexual transmission is also the main route of transmission of HIV,and sexual transmission between spouses accounts for about a quarter.A negative spouse of an HIV-infected person may become a highly exposed population because he does not understand the infection status of the partner and lacks appropriate protective measures.Sexual transmission among spouses in AIDS families has attracted widespread attention from relevant departments at home and abroad,as well as experts and scholars.Preventing HIV transmission among spouses has become an important part of HIV prevention and control.Scientific research has shown that antiviral therapy can significantly reduce the morbidity and mortality of HIV-infected patients and patients.At the same time,the successful implementation of large-scale anti-viral treatment can significantly reduce the viral load level of the population,prolong the survival period of patients,and effectively reduce the spread of AIDS.At present,many researchers at home and abroad have conducted a cohort study on single-yang families through large-scale and long-term follow-up,and explored the positive conversion of negative partner antibodies and the influencing factors.Domestic and foreign studies on single-yang families vary greatly depending on the study area,sample selection,sample size and follow-up time.Research on the efficacy of antiviral therapy in China to block the transmission of HIV-independent couples has also increased year by year.When limited by time,sample,etc.,Meta analysis is also an option to explore the risks of transmission within the family.It is the key to accurately formulate the search strategy for Meta analysis.It is necessary to read a large number of single-yang family related literatures,combined with PubMed's existing strategies,and finally refer to the Cochrane System Evaluation Manual.At the same time,all the information in the research comes from historical data(published Literature),this may miss some of the original important,but not yet published,real data,thus affecting the accuracy and reliability of the analysis conclusions,so it is necessary to supplement the manual reference to some relevant references of the qualified literature to ensure the precision and recall rate.The screening,exclusion and evaluation of literature quality are partly due to the fact that the meta-analysis method is a secondary comprehensive analysis of the original research,which is subject to the expert's professional knowledge,level of knowledge and quality of the included literature;In the case of large differences in the parameters of the paper,Meta analysis generally does not directly combine the results,and needs to be analyzed hierarchically;the time for starting treatment of single-yang family antiviral therapy is different,the drugs are different,the duration is different,and the chances of annual exposure are different,etc.Rates are not directly comparable.Based on such a background,this topic preliminarily adopts the network meta-analysis method to construct a network structure for each factor that affects the blocking effect,and achieves an indirect comparison of the blocking effect.Objective:To evaluate the effect of antiviral therapy in the real world on the transmission of HIV-positive couples in China.This is a general meta-analysis to summarize the occurrence of negative couples in HIV single-yang families in China.Evaluation of antiviral therapy by mesh meta-analysis Block the effect of transmission between husband and wife in HIV single-yang families in China;compare the blocking effect between different interventions.At the same time,the evaluation of foreign antiviral treatment to block the transmission of HIV single-yang family spouse and China's differences.Methods:A systematic review and reticular meta-analysis of the literature on the observational cohort study of HIV transmission among HIV-only single-family spouses published in China from June 1987 to Noveber 2018 was conducted in this study.By collecting antiviral therapy to block the literature on inter-marital transmission in HIV single-yang families,a meta-analysis of the included studies was conducted according to certain exclusion criteria and conclusions were drawn to provide a scientific basis for preventing HIV transmission among husbands and wives in single-yang families;At the same time,the mesh meta-analysis method was used to compare the different conditions of blocking the positive conversion of HIV single-yang family negative partners,and to evaluate the different treatment time,different drugs,different duration of continuous treatment,etc.The effect of the negative effect of the negative family spouse,thus providing optimal guidance and advice for antiviral treatment for HIV single-yang families.After selecting the research topic,the evidence-based medical methodology is used to determine the ideas of the meta-analysis,and to develop detailed search strategies,inclusion criteria,and exclusion criteria.The paper was finally included in the literature through reading and screening,and its quality evaluation and data extraction were carried out.Statistical software Stata14.0 was used for data processing and mesh meta-analysis.Results:1.Finally,30 observational cohort studies were included.After the merger,the positive conversion rate of negative couples in HIV serodiscordant couples was 1.29/100 person-years,and the 95%confidence interval was 1.1/100 person-years to 1.7/100 person-years.Subgroup analysis showed that the probands were male and female,and their spouses'positive conversion rates were 1.5/100 person-years and 3.5/100 person-years respectively;the original yang patients received and did not receive anti-viral treatment,and their spouses'positive conversion rate They are 0.6/100 person-years and 2.0/100 person-years respectively;those who never use and sometimes/have used condoms in their sexual life,the positive conversion rates of their negative spouses are:6.9/100 person-years,0.6/100 person-years;original Yang CD4 cells<200/?L,200-350/?L,>350/?L,the negative conversion rate of the negative spouse is 1.3/100 person-years,1.1/100 person-years,0.8/100 people Years;the frequency of sexual life between husband and wife?4 times/month and 1-4 times/month,the conversion rate of spouses is 1.8/100 person-years,0.7/person years.It can be seen that males in the original Yang,who do not insist on using condoms,do not receive antiviral therapy,CD4 cells<200/?L,sexual frequency?4 times/month are the risk factors affecting the transmission of HIV single-yang family.2.The general trend of anti-viral treatment blocking effect is that the protection rate of serodiscordant couples receiving ART treatment to prevent HIV infection of its negative partner decreased with the prolongation of follow-up time.3.Using the mesh meta-analysis method to start different time for anti-viral treatment of serodiscordant couples(different treatment time),different drugs(different treatment plans),different duration of treatment,different infection time,whether to change dressing,condom use The indirect comparison of the blocking effects of various factors affecting the blocking rate showed that the different treatment regimes had the greatest impact on the positive conversion of HIV serodiscordant couples negative partners,and the other factors affected the positive conversion.Time,condom,infection time,dressing change,continuous treatment time.Conclusion:Conclusion In the real world,antiviral therapy can block the spread of HIV-only couples in China,and in different evaluation measures,different treatment options have the greatest impact on the treatment of HIV single-yang family negative partners.The global positive rate of HIV single-positive negative partners in the world is Africa,North America,Asia,and Europe. |
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