吸毒人群HIV合并HCV感染的抗病毒治疗免疫学疗效及影响因素分析  

Immunological efficacy and influencing factors of antiviral treatment of HIV combined with HCV infection in drug addicts

作　　者：谭婷 陆林[2] 黄丽花[3] 陆梅泾[3] 陈志娟[3] TAN Ting;LU Lin;HUANG Li-hua;LU Mei-jing;CHEN Li-juan(Kunming Medical University, Yunnan, Kunming 650228, China;YunNan Provincial Center for Disease Control and Prevention;Dali Center for Disease Control and Prevention)

机构地区：[1]昆明医科大学,云南昆明650228 [2]云南省疾病预防控制中心 [3]云南省大理州疾病预防控制中心

出　　处：《中国公共卫生管理》2018年第3期295-299,共5页Chinese Journal of Public Health Management

摘　　要：目的分析云南省吸毒人群HIV合并HCV感染人群接受HIV抗病毒治疗后免疫学疗效及影响因素。方法2016年7-11月,在昆明市和大理州内的9家机构,包括7家美沙酮治疗门诊和2家强制戒毒所采用方便抽样方法开展横断面研究,调查HIV合并HCV感染的吸毒人员610例,回收有效问卷581份,有效回收率为95.3%。结果581例调查对象以男性、中年、未婚或离异、汉族、低文化程度和低收入人群为主。抗病毒治疗比例为74.4%(432/581),年龄<50岁或病程为6~8年的治疗人群末次基线CD4^+T细胞计数平均值高于未治疗人群(P<0.05)。接受HIV抗病毒治疗的432例中,有22.5%(97/432)的调查对象免疫学失败。对581例调查对象进行单因素分析显示,常居地、机构、是否知晓HIV、病程、基线CD4^+T细胞数值和治疗年限是影响免疫学失败的因素。Logistic回归分析结果显示,基线CD4^+T细胞计数越高,治疗年限越长,越不容易发生免疫学失败。结论抗病毒治疗有助于提高吸毒人群HIV合并HCV感染者的免疫功能,及时、长期接受HIV抗病毒治疗更不容易发生免疫学失败。Objective To analyze the immunological efficacy and influencing factors of antiviral treatment of HIV combined with HCV infection in drug addicts in Yunnan province. Methods During July and December in 2016,a cross-sectional study was conducted among subjects who was decided by convenience sampling in Kunming and Dali include 7 methadone maintenance treatment clinics and 2 compulsory detoxifications,610 subjects were investigated,581 questionnaire were effective. The effective recovery rate was 95. 3%. Results Five hundred and eighty-one subjects were mainly male,middle-aged,unmarried or divorced,Han,low education and low income people. In total,the treatment rate was 74. 4%（ 432/581）.The mean value of the last CD4＋T cell count in the treatment population aged 50 years or course of disease with 6 ～ 8 years were higher than that in the untreated group（ P〈0. 05）. Of the 432 subjects who have received antiretroviral therapy,22. 5%（ 97/432） had immunological failure. A single factor analysis of 581 cases showed that habitual residence,institutions,knowledge of HIV,course of disease,baseline CD4^＋ T cell number and duration of treatment were factors influencing immune failure. Logistic regression analysis showed that the people with higher baseline CD^＋4 T cell counts and had accepted treatment longer weren＇t more likely immunological failure. Conclusion Antiretroviral therapy is beneficial to the immune reconstruction among drug addicts with HIV and with HCV infection,timely and long-term antiretroviral treatments are not more likely to have immunological failure.

关 键 词：吸毒 HIV/AIDS HCV 抗病毒治疗 免疫 影响因素 

分 类 号：R512.91[医药卫生—内科学] R512.63[医药卫生—临床医学]