湖北省2003—2015年接受艾滋病HAART患者免疫学失败及影响因素分析  

Immunological failure of HAART and its influencing factors among AIDS patients in Hubei province, 2003–2015

作　　者：郑武[1] 笪琴[1] 张薇[1] 汤恒[1] 彭国平[1] ZHENG Wu;DA Qin;ZHANG Wei(Hubei Provincial Center for Disease Control and Prevention,Wuhan,Hubei Province 430079,China)

机构地区：[1]湖北省疾病预防控制中心,武汉433100

出　　处：《中国公共卫生》2018年第10期1403-1406,共4页Chinese Journal of Public Health

基　　金：湖北省科技厅公益性科技研究项目(2012DCA14001)

摘　　要：目的了解湖北省2003—2015年接受艾滋病高效抗逆转录病毒治疗(HAART)的患者状况,分析艾滋病HAART后免疫学失败及其影响因素。方法利用国家"艾滋病综合防治信息系统"进行筛选,描述分析艾滋病HAART状况及免疫学失败情况,通过含时间依存变量的Cox风险回归模型分析免疫学失败的影响因素。结果 8 996例患者纳入研究,总计随访60 018次,整个随访过程中有30.55%的研究对象发生了免疫学失败,中位失败时间为治疗后的47.67个月;拟合扩展的Cox风险模型,发现随访前7天漏服次数、性别、WHO临床分期、基线CD4+T淋巴细胞计数、年龄(≥50岁)、初始治疗方案等对免疫学失败有影响。结论接受HAART后艾滋病患者发生免疫学失败的影响因素较多,需提高患者的依从性,及早开展抗病毒治疗,特别要关注老年患者的治疗,并结合其他检测结果综合考虑治疗方案。Objective To examine the status of AIDS patients receiving highly active antiretroviral therapy（HAART） in Hubei province between 2003-2015 and to analyze the immunological failure of HAART and its influencing factors among the patients. Methods We extracted relevant data on AIDS patients receiving HAART from National Information System for Comprehensive AIDS Prevention and Control to analyze outcomes and immunological failure of HAART among the AIDS patients. The influencing factors of immunological failure of HAART were analyzed with Cox risk model involving time-dependent variables. Results Totally 60 018 follow-up visits were conducted among 8 996 AIDS patients enrolled.Immunological failure were identified among 30.55% of the patients being followed-up and the median time for the failures was 47.67 months from the beginning of HAART. The results of expanded Cox risk model analysis demonstrated that the number of missed dose of HAART during previous 7 days before the fellow-up, gender, clinical staging based on World Health Organization criterion, CD4＋ T lymphocyte baseline count, age（50 years old and above）, and the initial treatment scheme were impact factors for immunological failure of HAART among the patients. Conclusion Many factors influence the incidence of immunological failure among AIDS patients receiving HAART and improving therapeutic compliance,conducting antiviral therapy as early as possible, adopting appropriate treatment scheme, and paying special concern on the therapy for elderly patients are measures to decrease the immunological failure.

关 键 词：艾滋病 高效抗病毒治疗 CD4+T淋巴细胞 免疫学失败 

分 类 号：R512.91[医药卫生—内科学]