2012—2017年广西HIV-1单阳家庭阳性配偶未接受抗病毒治疗影响因素分析  

Factors affecting sero-positive partners failing to receive antiretroviral therapy among HIV-1 sero-discordant couples in Guangxi, 2012-2017

作　　者：朱秋映[1] 刘玄华[1] 黄精华[1] 吴秀玲[1] 陈欢欢[1] 唐振柱[1] 阮玉华[1,2] 邵一鸣 沈智勇[1] ZHU Qiu-ying;LIU Xuan-hua;HUANG Jing-hua;WU Xiu-ling;CHEN Huan-huan;TANG Zhen-zhu;RUAN Yu-hua;SHAO Yi-ming;SHEN Zhi-yong(Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention,Nanning,Guangxi 530028,China;State Key Laboratory of Infectious Disease Prevention and Control,Chinese Center for Disease Control and Prevention,Beijing 100050,China)

机构地区：[1]广西壮族自治区疾病预防控制中心,广西南宁530028 [2]中国疾病预防控制中心传染病预防控制国家重点实验室,北京100050

出　　处：《实用预防医学》2020年第11期1324-1328,共5页Practical Preventive Medicine

基　　金：广西科技重点研发计划(桂科:AB16380213);广西八桂学者艾滋病防控关键技术岗位专项;国家科技重大专项(2018ZX10721102、2018ZX10715008)

摘　　要：目的了解HIV-1单阳家庭阳性配偶未接受抗病毒治疗情况及相关影响因素。方法从国家艾滋病防治基本信息系统中下载数据库,采用回顾性研究方法,利用Cox比例风险模型分析2012—2017年报告的单阳家庭阳性配偶/固定性伴抗病毒治疗情况及未治疗的影响因素。结果截至2017年12月31日,纳入分析的研究对象为13191例,HIV-1单阳家庭阳性配偶/固定性伴抗病毒治疗率为86.65/100人年。Cox回归结果显示:2013—2017年治疗率是2012年的1.17~1.54倍(95%CI:1.09~1.65);女性是男性的1.07倍(95%CI:1.01~1.13);≥50岁组是18~49岁组的0.50~0.87倍(95%CI:0.46~0.91);同居是已婚有配偶的0.89倍(95%CI:0.81~0.97);壮族是汉族的1.06倍(95%CI:1.02~1.11);初中及以上文化程度是小学及以下的1.13~1.24倍(95%CI:1.08~1.33);最近一次CD4细胞计数为≥200个/μl组是<200个/μl组的0.45~0.95倍(95%CI:0.42~1.00),CD4未检测组是<200个/μl组的0.28倍(95%CI:0.24~0.33);样本来源于医疗机构、婚/孕/产检、其他,分别是咨询检测的0.91倍(95%CI:0.87~0.96)、0.78倍(95%CI:0.72~0.84)、0.72倍(95%CI:0.65~0.79)。结论为进一步提高单阳配偶抗病毒治疗率,控制单阳家庭内传播,应根据影响治疗的相关因素制定针对性应对策略,切实做好治疗动员工作,重点关注老年人、低文化程度者以及CD4细胞计数较高者,引导患者及早进行抗病毒治疗。Objective To understand the situation and related influencing factors of sero-positive partners failing to receive antiretroviral therapy(ART)in HIV-1 sero-discordant couples in Guangxi from 2012 to 2017.Methods Data were collected from the National Basic Information System for HIV/AIDS Prevention and Control.Retrospective study method and cause-specific Cox proportional hazard models were used to analyze the situation of sero-positive partners or fixed sexual partners receiving ART and the factors affecting them failing to receive ART in HIV-1 sero-discordant couples in Guangxi during 2012-2017.Results A total of 13,191 cases were enrolled in this study as of December 31,2017,and the rate of receiving ART in sero-positive partners or fixed sexual partners in HIV-1 sero-discordant couples was 86.65 per 100 person-years.Results from Cox proportional hazard models revealed that the related factors and AHRs for ART rate appeared as:HIV positive confirmation in 2013-2017(vs.2012,AHR=1.17-1.54,95%CI:1.09-1.65),females(vs.males,AHR=1.07,95%CI:1.01-1.13),the group aged≥50 years(vs.the group aged 18-49 years,AHR=0.50-0.87,95%CI:0.46-0.91),cohabitants(vs.the married,AHR=0.89,95%CI:0.81-0.97),Zhuang ethnic group(vs.Han ethnic group,AHR=1.06,95%CI:1.02-1.11),junior high school education level or above(vs.primary school or below,AHR=1.13-1.24,95%CI:1.08-1.33),the group with recent CD4 count≥200 cells/μl(vs.the group with recent CD4 count<200 cells/μl,AHR=0.45-0.95,95%CI:0.42-1.00),the group without CD4 cell testing(vs.the group with CD4 count<200 cells/μl,AHR=0.28,95%CI:0.24-0.33),and samples from medical institutions(vs.HIV voluntary counseling and testing(VCT),AHR=0.91,95%CI:0.87-0.96),from premarital check-up/pregnancy testing/prenatal examination(vs.VCT,AHR=0.78,95%CI:0.72-0.84)and from other sources(vs.VCT,AHR=0.72,95%CI:0.65-0.79).Conclusions Corresponding strategies should be made based on the related factors influencing ART so as to further improve the ART rate in sero-positive partners and control HIV-1 trans

关 键 词：艾滋病病毒 阳性配偶 回顾性研究 抗病毒治疗 

分 类 号：R512.91[医药卫生—内科学]