山东省HIV感染者和艾滋病患者抗病毒治疗及时性及影响因素分析  

An analysis of factors associated with timeliness of antiretroviral therapy among HIV/AIDS in Shandong province

作　　者：朱晓艳[1] 黄涛[1] 王国永[1] 廖玫珍[1] 黄鹏翔[1] 张娜[1] 郝连正[1] 杨兴光[1] 康殿民[1] Zhu Xiaoyan;Huang Tao;Wang Guoyong;Liao Meizhen;Huang Pengxiang;Zhang Na;Hao Lianzheng;Yang Xingguang;Kang Dianmin(Shandong Provincial Center for Disease Control and Prevention,Jinan 250014,China)

机构地区：[1]山东省疾病预防控制中心,济南250014

出　　处：《中华实验和临床病毒学杂志》2021年第4期361-366,共6页Chinese Journal of Experimental and Clinical Virology

基　　金：山东省自然科学基金青年基金(ZR2014HQ038);山东省医药卫生科技发展计划(2017WS457,2019WS427)。

摘　　要：目的:分析山东省2017—2019年入组治疗的HIV/AIDS抗病毒治疗的及时性和影响因素。方法:数据来源于国家艾滋病综合防治数据信息系统,入组抗病毒治疗时间为2017年1月1日至2019年12月31日,启动抗病毒治疗年龄≥15岁的中国内地籍HIV/AIDS为研究对象。纳入分析的变量包括人口学特征(性别、年龄、民族、文化程度、婚姻状况等)、感染途径、样本来源、诊断日期、基线CD4+T细胞水平、临床分期等。采用χ^(2)检验对不同特征的研究对象及时治疗情况进行单因素分析,采用Logistic逐步回归分析研究对象及时抗病毒治疗的影响因素。结果:7425例HIV/AIDS中,男性6813例(91.8%),同性性传播5236例(70.5%),开始治疗时年龄为(36.05±12.51)岁,符合治疗标准的HIV/AIDS确证后30天内入组抗病毒治疗的比例从2017年的55.9%(1145/2050)上升到2019年的65.3%(1821/2789),已婚或同居、高中及以上学历的HIV/AIDS及时治疗可能性较高,OR值分别为1.136、1.299;外省的HIV/AIDS及时治疗可能性低于本省者,OR值为0.664;≥55、45~54、35~44岁组HIV/AIDS及时治疗可能性高于15~24岁年龄组,OR值分别为1.530、1.505、1.394;经异性性传播的HIV/AIDS及时治疗可能性低于同性性传播感染者,OR值为0.803;样本来源为羁押场所的及时治疗可能性低于样本来源为检测咨询的病例,OR值为0.204;治疗基线CD4+T淋巴细胞>500(个/μl)的病例及时治疗可能性低于≤500者,OR值为0.545;基线无临床症状者治疗及时的可能性低于有症状者,OR值为0.727;基线临床分期为Ⅳ期的HIV/AIDS治疗及时性高于基线临床分期为Ⅰ、Ⅱ、Ⅲ期者,OR值为1.307。以上P值均<0.05。结论:2017—2019年山东省符合抗病毒治疗标准的HIV/AIDS入组治疗及时率不断提高。婚姻状况、文化程度、年龄、样本来源、感染途径、基线临床分期和CD4+T淋巴细胞水平等和治疗及时性相关。Objective To analyze the timeliness and influencing factors of antiretroviral treatment(ART)among HIV/AIDS patients from 2017 to 2019 in Shandong province.Methods Data were collected from the Chinese HIV/AIDS Comprehensive Response Information Management System,HIV/AIDS cases enrolled in antiretroviral therapy,from January 1,2017 to December 31,2019,≥15 years of age and from the mainland of China were the subjects of the study.The general demographic characteristics(gender,age,ethnicity,education level,marital status,etc),infection routes,sample sources,date of diagnosis,baseline CD4+T cell level,and clinical stage and other information were collected from the database.Univariate analysis was conducted for the timeliness of ART of the subjects by Chi square test,and the influencing factors associated with timeliness of ART were analyzed by binary non-conditional Logistic regression.Results Among the 7425 cases of HIV/AIDS,6813(91.8%)were male,5236(70.5%)had homosexual transmission,the age at the ART initiation was(36.05±12.51)years.The proportion of timeliness of ART within 30 d increased from 55.9%(1145/2050)in 2017 to 65.3%(1821/2789)in 2019.The possibility of timeliness of ART among HIV/AIDS who were married or cohabiting,education of high school and above were higher,with OR values at 1.136,1.299.The possibility of timeliness of ART among HIV/AIDS cases whose domicile place is outside Shandong province were lower,with OR values at 0.664.The possibility of timeliness of ART in group of HIV/AIDS aging≥55,45~54 and 35~44 years old were higher than that in 15~24 years old,with OR values at 1.530,1.505 and 1.394.The possibility of timeliness of ART among the heterosexuals were lower than that of homosexuals,with OR values at 0.803.The possibility of timeliness of ART is lower for cases in places of detention centers than cases from volunteer testing and counseling,with OR values at 0.204.The possibility of timeliness of ART among HIV/AIDS cases whose CD4+T lymphocyte at>500 cells/μL were lower than that of t

关 键 词：HIV 抗病毒治疗 及时性 

分 类 号：R51[医药卫生—内科学]