贵阳市2005-2019年报告经男男性行为感染的HIV/AIDS患者首次CD4细胞检测情况  

First CD4+T lymphocyte test of newly reported HIV/AIDS positive case by homosexual behavior transmission in Guiyang From 2005 to 2019

作　　者：佘敏[1] 周健[1] 袁飞[1] 张欐 祝继[1] 杨琴[1] 马璐[1] 李劲[1] 刘杨晶 SHE Min;ZHOU Jian;YUAN Fei;ZHANG Li;ZHU Ji;YANG Qin;MA Lu;LI Jin;LIU Yangjing(Guiyang Center for Disease Control and Prevention,Guiyang 550003,China)

机构地区：[1]贵阳市疾病预防控制中心,贵阳550003

出　　处：《中国艾滋病性病》2021年第6期628-631,共4页Chinese Journal of Aids & STD

摘　　要：目的了解2005-2019年贵阳市新报告经男男性行为感染的HIV/AIDS患者特征,分析CD4细胞检测及时性和结果,探索相关影响因素。方法使用"艾滋病综合防治信息系统"截至2019年12月31日的病例报告历史卡片和随访数据库,运用卡方检验和二分类Logistic回归模型等方法,对HIV/AIDS患者首次CD4细胞检测情况进行分析比较。结果2005-2019年贵阳市共报告2151例经男男性行为感染的HIV/AIDS患者,其中HIV感染者和AIDS患者所占比例分别为72.6%和27.4%。HIV/AIDS患者确证后14天内检测CD4细胞所占的比例为48.3%,多因素分析结果显示,户籍地是外省(OR=1.54,95%CI:1.16~2.03)和本省其他地区(OR=1.55,95%CI:1.25~1.91),初中及以下(OR=1.34,95%CI:1.01~1.76),2005-2009年(OR=2.86,95%CI:2.08~3.93)和2010-2014年(OR=2.13,95%CI:1.75~2.59)报告的病例确证后及时进行CD4细胞检测的比例较低;来源于咨询检测病例(OR=0.44,95%CI:0.36~0.53)及时进行CD4细胞检测的比例较高。HIV/AIDS患者CD4细胞计数<350个/μL比例为50.7%,多因素Logistic回归分析结果显示,35~44岁组(OR=2.05,95%CI:1.16~3.64)和45岁以上组(OR=2.57,95%CI:1.32~5.02),在婚(OR=1.71,95%CI:1.12~2.62)、来源于医疗机构(OR=1.92,95%CI:1.21~3.05)、2010-2014年(OR=1.41,95%CI:1.02~1.93)和2015-2019年(OR=1.95,95%CI:1.44~2.65)报告的HIV/AIDS患者晚发现比例更高。结论贵阳市报告经男男性行为感染HIV/AIDS患者数多,确证后及时进行CD4细胞检测的比例低,晚发现的比例高,针对相关影响因素,应继续扩大男男性行为者的HIV检测覆盖面,做到早发现,早管理和早治疗。Objective To understand the CD4+T lymphocyte testing and its influencing factors among newly reported HIV/AIDS patients transmitted through MSM in Guiyang from 2005 to 2019.Methods We analyzed data from the case report history card and the follow-up database of the National Information System for Comprehensive AIDS Prevention and Control as of 31 December 2019.We used the chi-square test and binary logistic regression model to explore the influencing factors associated with the first CD4 cells testing after HIV diagnosis.Results A total of 2,151 MSM were newly reported as HIV infection in Guiyang from 2005 to 2019,among which 27.4%were AIDS.The proportion of CD4 cells tested within 14 days after HIV diagnosis was 48.3%.The multivariate logistic regression analysis showed MSM who had a lower proportion of CD4 cells tested in time after HIV diagnosis were those with a domicile of other provinces(OR=1.54,95%CI=1.16~2.03),with a domicile from other city of Guizhou province(OR=1.55,95%CI=1.25~1.91),having an education level of junior high school and below(OR=1.34,95%CI=1.01~1.76),being reported as HIV between 2005 and 2009(OR=2.86,95%CI=2.08~3.93),and being reported as HIV between 2010 and 2014(OR=2.13,95%CI=1.75~2.59).People diagnosed at voluntary counseling and testing sites tended to have a higher in time CD4 cell testing rate(OR=0.44,95%CI=0.36~0.53).More than half(50.7%)of MSM in our study had a CD4 cell count<350 cell/μL at HIV diagnosis.The multivariate logistic regression analysis showed MSM who had a lower level CD4 count were those in the 35-44 age group(OR=2.05,95%CI=1.16~3.64),in the 45 and over group(OR=2.57,95%CI=1.32~5.02),being marriage(OR=1.71,95%CI=1.12~2.62),being diagnosed at medical institutions(OR=1.92,95%CI=1.21~3.05),being reported between 2010 and 2014(OR=1.41,95%CI=1.02~1.93),and being reported between 2015 to 2019(OR=1.95,95%CI=1.44~2.65).Conclusion There is a large HIV-positive MSM community in Guiyang City.Strategies are needed to strengthen the HIV testing coverage and early CD4 testing

关 键 词：男男性行为 艾滋病病毒感染者/艾滋病患者 CD4细胞 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]