云南省德宏州HIV感染者阴性配偶队列5年失访率及其影响因素  

Loss to follow-up over the first five years and its influencing factors in the cohort of sero-negative spouses of HIV-infected individuals in Dehong Prefecture,Yunnan Province

作　　者：张玉成[1] 曹艳芬[2] 杨跃诚[2] 唐仁海[2] 杨世江[2] 李林[2] 姚仕堂[2] 叶润华[2] 王继宝[2] 段松[2] 何纳[1] 

机构地区：[1]复旦大学公共卫生学院流行病学教研室,上海200032 [2]德宏州疾病预防控制中心性病艾滋病防制科,云南芒市678400

出　　处：《中华疾病控制杂志》2016年第12期1274-1277,1298,共5页Chinese Journal of Disease Control & Prevention

基　　金：国家重点地区艾滋病防治项目(2004年);“十一五”国家科技重大专项(2008ZX10001016-006);“十二五”国家科技重大专项(2012ZX10001001-004);国家自然科学基金(81373062,81072345)

摘　　要：目的 了解云南省德宏州人类免疫缺陷病毒（human immumodeficiency virus,HIV）感染者阴性配偶队列失访情况及影响因素。方法 以2009年招募进入队列的德宏州1110例阴性配偶为研究对象,收集其社会人口学信息、HIV相关信息,每年随访一次,至2014年12月底结束。利用COX比例风险模型分析阴性配偶失访的影响因素。结果 1110例阴性配偶中,有37例新发感染HIV,总发病密度为0.92/100人年。1015例（91.4%）的研究对象至少随访了一次。到2014年底,有227例失访,4例死亡,129例感染者配偶死亡,63例离异。5年队列保持率为58.7%（652/1110）,可随访阴性配偶占应随访的74.2%（652/879）,总失访密度为5.66/100人年。COX比例风险模型分析显示来自瑞丽市（HR=1.83,95%CI：1.16~2.87,P=0.009）、芒市（HR=1.90,95%CI：1.23~2.93,P=0.004）,男性（HR=1.74,95%CI：1.27~2.38,P=0.001）,阳性配偶未接受抗病毒治疗（HR=4.39,95%CI：3.21~6.02,P〈0.001）的阴性配偶失访率较高。结论 居住在瑞丽市、芒市,男性,阳性配偶未接受抗病毒治疗的阴性配偶失访风险较高。为提高阴性配偶队列保持率,德宏州艾滋病防治机构需在今后的工作中考虑以上因素的影响。Objective To explore the factors influencing the loss to follow-up over the first five years among seronegative spouses of HIV-infected individuals in Dehong Prefecture, Yunnan Province. Methods A total of 1 110 HIV seronegative spouses were recruited in 2009, social-demographic characteristics and HIV/AIDS related information were collected, follow-up survey was conducted every year till the end of 2014. COX proportional hazards regression model was used to analyze risk factors of loss to follow-up. Results Among total 1 110 seronegative spouses recruited, HIV seroconvertion was developed in 37 subjects with a total incidence rate of 0. 92 per 100 person years. 1 015（91.4% ） had at least one follow-up visit, however, 227 lost to follow-up at the end of 2014, contributing to a rate of 5.66 per 100 person years, four subjects and 129 seropositive subjects died, 63 divorced. The retention rate was 58.7% （652/1 110） at 5 years. Of all sero-negative spouses who needed follow-up, 74. 2% （652/879） performed follow-up visit. COX proportional hazards regres- sion model showed that the risk factors of loss to follow-up were living in Ruili （HR = 1, 83,95% CI： 1. 16-2. 87, P= 0.009） or Mangshi （HR=1.90,95% CI：1.23-2.93,P=0.004）, male （HR=1.74,95% C1：1.27-2.38,P=0.001） and having sero-positive spouses not under anti-retroviral therapy （ART） （HR = 4. 39,95% CI：3.21-6. 02, P 〈 0. 001 ）. Conclusions Living in Ruili or Mangshi, male and having seropositive spouses not under ART are risk factors of loss to follow-up. To maintain a high retention rate, the institute of HIV/AIDS prevention and control in Dehong prefecture should pay more attention to these influencing factors in the future work.

关 键 词：人免疫缺陷病毒 配偶 队列研究 

分 类 号：R512.91[医药卫生—内科学] R181.2[医药卫生—临床医学]