湖南省2014—2018年HIV/AIDS患者免费抗病毒治疗情况及影响因素分析  

Coverage and influencing factors of free antiretroviral therapy among HIV/AIDS patients in Hunan province,2014-2018

作　　者：魏秀青[1] 贺健梅[1] 郑军[1] 覃碧云[1] 张园园[1] 陈曦[1] WEI Xiu-qing;HE Jian-mei;ZHENG Jun;QIN Bi-yun;ZHANG Yuan-yuan;CHEN Xi(Hunan Provincial Center for Disease Control and Prevention,Changsha9 Hunan 410005,China)

机构地区：[1]湖南省疾病预防控制中心,湖南长沙410005

出　　处：《实用预防医学》2020年第9期1044-1047,共4页Practical Preventive Medicine

基　　金：国家科技重大专项(No.2017ZX10201101002009)。

摘　　要：目的分析2014-2018年湖南省艾滋病抗病毒治疗开展情况及影响因素,为实现"治疗90%、有效90%"的目标提供参考和依据。方法利用湖南省2014-2018年随访管理数据库和抗病毒治疗管理数据库,采用Excel 10.0及SPSS 20.0软件,计算抗病毒治疗比例和治疗成功率,计算不同年度新报告HIV/AIDS患者纳入抗病毒治疗的时间分布,分析2018年湖南省存活HIV/AIDS接受抗病毒治疗的影响因素及不同特征对抗病毒治疗比例的影响。结果 2014-2018年间,湖南省抗病毒治疗比例从67.2%上升到86.7%,治疗成功率从90.8%上升到94.4%,确证后30 d内纳入抗病毒治疗的比例从38.1%上升到55.9%,女性(OR:1.17,95%CI:1.08~1.27)、25~50岁人群(OR:1.32,95%CI:1.18~1.48)和>50岁人群(OR:1.47,95%CI:1.28~1.68)、已婚或有配偶(OR:2.03,95%CI:1.86~2.22)、离异或丧偶(OR:1.45,95%CI:1.32~1.60)、最近一次CD4^+ T淋巴细胞<200个/μl(OR:1.50,95%CI:1.35~1.67)等因素人群抗病毒治疗比例较高。结论抗病毒治疗及时性和治疗比例仍需要进一步提高,性别为男性、年龄≤24岁、异性传播及注射毒品、未婚、高CD4^+ T淋巴细胞水平(>500个/μl)及未及时进行CD4^+T细胞检测等因素是患者接受抗病毒治疗的不利因素,需针对不同特征人群采取有效措施,加大治疗宣教力度及规范管理,进一步提高治疗比例。Objective To analyze the coverage of antiretroviral therapy and its influencing factors in Hunan province from 2014 to 2018, and to provide evidence for realizing the goal of 90% of diagnosed people on treatment and 90% of those on treatment virally suppressed. Methods We selected the case data from epidemiological follow-up database and management database of antiretroviral treatment in Hunan province in 2014-2018. Excel 10.0 and SPSS 20.0 were used for calculating the proportion and success rate of antiretroviral therapy and the time distribution of entering antiretroviral therapy of newly-reported HIV/AIDS patients in different years, and analyzing the factors influencing alive patients with HIV/AIDS receiving antiretroviral therapy in 2018 and the impact of different characteristics on the proportion of antiretroviral therapy. Results The proportion of antiretroviral treatment in Hunan province in 2014-2018 increased from 67.2% to 86.7%, the success rate of treatment increased from 90.8% to 94.4%, and the proportion of antiretroviral therapy recruited in 30 days after confirmation increased from 38.1% to 55.9%. The patients who were female(OR:1.17,95%CI:1.08-1.27), 25-50 years old(OR:1.32,95%CI:1.18-1.48) and above 50 years old(OR:1.47,95%CI:1.28-1.68), married or had a spouse(OR:2.03,95%CI:1.86-2.22), divorced or widowed(OR:1.45,95%CI:1.32-1.60) and had CD4^+ T-cell count < 200 cells/μl at the last detection(OR:1.50,95%CI:1.35-1.67) were inclined to take a higher proportion of antiretroviral treatment. Conclusions The timeliness and proportion of antiretroviral treatment need to be further improved. The males aged ≤ 24 years, heterosexual transmission and injecting drugs, the unmarried, high CD4^+ T-cell count(>500 cells/μl) and failure to timely detect CD4^+ T-cell are the adverse factors influencing patients accepting antiretroviral treatment. It is necessary to take effective measures based on populations with different characteristics and strengthen the propaganda and education about the therapy and

关 键 词：艾滋病 抗病毒治疗 治疗比例 治疗成功率 影响因素 

分 类 号：R512.91[医药卫生—内科学]