武汉市2010—2018年新发现HIV/AIDS病例首次CD4细胞检测相关因素分析  

Related factors of first CD4 cell count test for newly detected HIV/AIDS cases in Wuhan from 2010 to 2018

作　　者：丁洁[1] 闫晗 吴斯[1] 马红飞 王夏[1] 谢年华[1] DING jie;YAN Han;WU Si;MA Hong-fei;WANG Xia;XIE Nian-hua(Wuhan Center for Disease Control and Prevention,Wuhan,Hubei 430024,China)

机构地区：[1]武汉市疾病预防控制中心,湖北武汉430024

出　　处：《现代预防医学》2021年第8期1503-1506,共4页Modern Preventive Medicine

基　　金：武汉市卫生计生委医学科研计划资助项目(WG18A06)。

摘　　要：目的分析武汉市2010—2018年新发现HIV/AIDS病例首次CD4细胞检测相关因素。方法根据国家艾滋病综合防治信息系统,获取武汉市2010—2018年病例历史卡片和随访数据库,对2010年1月1日—2018年12月31新发现HIV/AIDS病例相关信息进行分析。结果 2010—2018年间,新报告16岁及以上HIV/AIDS 5 404例,新报告病例数呈现逐年上升的趋势;HIV/AIDS在报告后14 d内接受首次CD4细胞检测的比例由2010年的42.0%上升至2018年的75.4%(χ^(2)趋势=251.594,P<0.001)。CD4细胞及时检测率在不同年龄、性别、样本来源方面差异有统计学意义(P<0.05),晚发现比例呈上升趋势;多因素分析显示,报告年份、性别、婚姻状态、文化程度、职业、感染途径、性病史、样本来源和人口性质是影响CD4细胞检测及时性的相关因素;年龄、婚姻状态、职业、感染途径、性病史及样本来源是影响晚发现的相关因素。结论武汉市2010—2018年间新发现HIV/AIDS首次CD4细胞检测比例和及时性均有明显提升,社会组织管理模式对首次CD4细胞检测及时性和晚发现方面起到积极作用,但总体晚发现现象仍然比较严重,50岁及以上、已婚有配偶、无稳定职业以及因症状就诊的患者是重点关注人群,进一步动员社会力量参加艾滋病防治工作,在全社会推广防艾宣传教育、扩大检测覆盖面,完善检测体系,提高患者发现率是当前应该努力的方向。Objective To analyze the related factors of first CD4 count test cell for newly detected HIV/AIDS cases in Wuhan from 2010 to 2018.Methods Data were collected from HIV/AIDS case reporting cards and follow-up cards from 2010 to 2018,which were obtained from HIV/AIDS Comprehensive Response Information Management System.Results From 2010 to 2018,a total of 5404 HIV/AIDS cases aged 16 and above were reported with an increasing trend year by year.The proportion of HIV/AIDS patients who received their first CD4 cell test within 14 days of reporting increased from 42.0%in 2010 to 75.4%in 2018(trendχ^(2)=251.594,P<0.001).The difference in the rate of timely CD4 cell testing was statistically significant(P<0.05)by age,sex,and sample source,with an increasing trend in the proportion of late detection.Multifactorial analysis showed that year of reporting,sex,marital status,education level,occupation,route of infection,STD history,sample source,and nature of the population were the factors affecting the timeliness of CD4 cell testing.Age,marital status,occupation,route of infection,STD history and sample source were the factors associated with late detection.Conclusion The proportion and timeliness of the first CD4 test for newly detected HIV/AIDS cases in Wuhan have been significantly increased from 2010 to 2018.The management model of social organizations plays a positive role in the timeliness of the first CD4 cell count test and late detection,but the rate of late diagnosis is still relatively serious.We should pay attention to cases who aged 50 and over,married,no stable occupation and went to hospital with symptoms.At present,we should strive to mobilize social forces to participate in AIDS prevention and control,promote AIDS prevention related publicity and education in the whole society,expand the coverage of testing,and improve the detection system to improve the rate of detection for HIV/AIDS cases.

关 键 词：HIV/AIDS 首次CD4细胞检测 晚发现 

分 类 号：R512.91[医药卫生—内科学]