2003—2019年四川省成人艾滋病抗病毒治疗效果评价  

Assessment of the effectiveness of antiretroviral therapy in HIV-positive adults in Sichuan Province from 2003 to 2019

作　　者：曾亚莉[1] 喻航[1] 杨薇[1] 李恬[1] 李菊梅 卓玛拉措 龚毅[1] 苏玲[1] 袁风顺 张灵麟[1] 赖文红[1] ZENG Ya-li;YU Hang;YANG Wei;LI Tian;LI Ju-mei;ZHUOMA La-cuo;GONG Yi;SU Ling;YUAN Feng-shun;ZHANG Ling-lin;LAI Wen-hong(Sichuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China)

机构地区：[1]四川省疾病预防控制中心,成都610041

出　　处：《预防医学情报杂志》2022年第5期587-593,共7页Journal of Preventive Medicine Information

基　　金：四川省科技厅项目(项目编号:2020YJ0449)。

摘　　要：目的分析2003—2019年四川省开展艾滋病抗病毒治疗工作的进展与效果。方法采用回顾性队列研究和多次横断面调查方法研究2003—2019年四川省成人艾滋病抗病毒治疗者人群特征、治疗进展和治疗效果。采用SAS 9.4软件进行统计分析,应用寿命表法计算治疗者生存概率,应用Log-rank检验比较不同基线CD4水平生存概率的差异。结果共166514例HIV感染者/AIDS病人接受治疗,其中2018—2019年新治疗者占47.68%,年度治疗覆盖率于2019年首次达到90%。治疗基线CD4计数<200 cells/μl者从2006年之前的95.65%,降至2019年的33.14%。医院入组病例占比从2005年的11.54%增加到2019年的70.94%。病毒载量检测比例从2010年的83.48%增至2019年的94.92%。病毒学失败比例从2008年的42.86%下降到2019年的9.21%。接受治疗者1、5和10年生存率依次为93.82%、80.51%和67.87%。不同基线CD4水平者生存率差异有统计学意义(χ^(2)=3278.40,P<0.001)。结论四川省艾滋病抗病毒治疗管理体系趋于合理、治疗人数增加迅速,治疗覆盖率和有效率均达到了90%,但近一半的感染者入组治疗时间尚不足2年,高基线CD4计数病例长期存活状况尚不理想,治疗有效率和生存率较国内经济、医疗技术发达地区有一定差距,艾滋病抗病毒治疗仍需持续投入与发展。Objective To analyze the progress and effectiveness of HIV(human immunodeficiency virus)antiretroviral therapy(ART)in Sichuan Province from 2003 to 2019.Methods The retrospective cohort study and multiple cross-sectional analysis were conducted to analyze the sociodemographic characteristics,progress and effectiveness of the antiretroviral therapy among HIV-positive adults in Sichuan Province from 2003 to 2019.SAS 9.4 was used for data analysis.Life table method was used to calculate the survival probability and Log-rank method was used to compare the difference of survival probability of cases with different baseline CD4 cell count levels.Results A total of 166514 cases received treatment,among which 47.68%newly started the treatment in 2018 or 2019.The annual treatment coverage rate reached 90%in 2019 for the first time.The proportion of the adults with baseline CD4 count<200 cells/μl decreased from 95.65%in 2006 to 33.14%in 2019.The proportion of cases enrolled from hospitals increased from 11.54%in 2005 to 70.94%in2019.The rate of viral load detection rose from 83.48%in 2010 to 94.92%in 2019,while the rate of virological failure declined from 42.86%in 2008 to 9.21%in 2019.The 1-,5-and10-year survival rate was 93.82%,80.51%and 67.87%,respectively.There was statistically significant difference in survival rate among adults with different baseline CD4 cell count levels(χ^(2)=3278.40,P<0.001).Conclusions The management system of HIV antiretroviral therapy in Sichuan Province trends to be rational.The number of cases received treatment increased rapidly,and the coverage rate and the efficiency of ART both reached 90%.However,nearly half of the cases had been treated less than 2 years.The long-term survival of patients with high baseline CD;count is not ideal.And there actually exists a certain gap in the treatment efficiency and survival rate compared with domestic economic and medical technology developed areas.Thus,continuous investment and development are still needed for ART.

关 键 词：艾滋病病毒 高效抗反转录病毒治疗 覆盖率 病毒学失败率 生存率 

分 类 号：R512.91[医药卫生—内科学]