2010—2019年凉山州艾滋病抗病毒治疗效果及相关因素分析  

Analysis of the effect and influencing factors of antiviral treatment among HIV/AIDS patients in Liangshan Prefecture from 2010 to 2019

作　　者：车双双 黄玉玲 曾亚莉[2] 杨薇[2] 任建华 张芹[1] 高鑫 蒋勇[2] 何丹[3] 杨一挥[2] CHE Shuang-shuang;HUANG Yu-ling;ZENG Ya-li;YANG Wei;REN Jian-hua;ZHANG Qin;GAO Xin;JIANG Yong;HE Dan;YANG Yi-hui(Nanchong Center for Disease Control and Prevention,Nanchong 637000,Sichuan Province,China;Sichuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China;Sichuan Maternal and Child Health Hospital,Chengdu 610041,Sichuan Province,China)

机构地区：[1]南充市疾病预防控制中心,四川南充637000 [2]四川省疾病预防控制中心,成都610041 [3]四川省妇幼保健院,成都610041

出　　处：《预防医学情报杂志》2022年第10期1321-1328,共8页Journal of Preventive Medicine Information

基　　金：四川省科技计划项目(项目编号:2020YJ0449);四川省疾病预防控制中心科研课题(项目编号:ZX201901);四川省科技计划重点研发项目(项目编号:2020YFS0425)。

摘　　要：目的了解四川省凉山州2010—2019年初始抗病毒治疗HIV/AIDS患者治疗效果及其影响因素,为进一步完善抗病毒治疗工作提供依据。方法采用回顾性队列研究的方法,从国家“艾滋病综合防治信息系统”中“抗病毒治疗信息系统”选取2010—2019年现住址在凉山州已经开始抗病毒治疗(HAART)的HIV/AIDS患者,共12460例,数据核查后运用SPSS 17.0软件进行χ^(2)检验、多因素Logistic回归统计分析。结果患者的平均年龄为(37.20±11.88)岁,至随访观察终止时间,抗病毒治疗成功10074例,成功率为80.85%;多因素Logistic回归分析结果显示女性(OR=1.174)、初中文化程度(OR=1.357)、治疗前BMI<18.5(OR=1.280)或≥24(OR=1.404)和攻坚后(OR=2.421)是患者治疗后艾滋病病毒载量(virus load,VL)有效抑制的保护性因素;汉族(OR=0.812)、离异或丧偶(OR=0.796)、静脉吸毒(OR=0.874)、启动治疗时WHO临床Ⅱ期(OR=0.733)或启动治疗时WHO临床Ⅲ期(OR=0.593)、县级及以上医院治疗随访机构、治疗过程中曾脱失是患者治疗VL有效抑制的危险性因素。结论凉山州HIV/AIDS患者抗病毒治疗成功率提高显著,还应针对病毒学失败影响因素采取措施,进一步提高抗病毒治疗成功率。为进一步提高凉山州HIV/AIDS患者抗病毒治疗效果,可以通过及早发现影响因素早期对患者治疗依从性进行干预,加强追踪随访和管理进而提高抗病毒治疗成功率。Objective To understand the therapeutic effect and influencing factors of initial antiretroviral therapy for HIV/AIDS patients in Liangshan Prefecture,Sichuan Province from 2010to 2019,and to provide basis for further improvement of antiretroviral therapy.Methods The retrospective cohort study method was used to select HIV/AIDS patients who started antiretroviral therapy(HAART)in Liangshan Prefecture from 2010 to 2019 from the Antiretroviral Treatment Information System in the National AIDS Comprehensive Prevention Information System.A total of12460 cases were enrolled.SPSS 17.0 software was used forχ^(2)test and multivariate logistic regression statistical analysis after data verification.Results The average age of the patients was37.20±11.88 years old.By the end of follow-up observation,10074 cases of antiviral treatment were successful,and the success rate was 80.85%.Multivariate logistic regression analysis showed that female(odds ratio(OR)=1.174),junior high school education(OR=1.357),pre-treatment BMI(body mass index)<18.5(OR=1.280)or≥24(OR=1.404)and after tackling(OR=2.421)were protective factors for the effective inhibition of HIV viral load(VL)after treatment;Han nationality(OR=0.812),divorced or widowed(OR=0.796),intravenous drug abuse(OR=0.874),WHO(World Health Organization)clinical phase II(OR=0.733)or III(OR=0.593)at the start of treatment,treated and followed up in hospitals at county level or above,and loss during treatment were risk factors for effective inhibition of VL in patients.Conclusions Liangshan Prefecture has significantly improved the success rate of antiviral treatment for HIV/AIDS patients.Measures should be taken to further improve the success rate of antiviral treatment according to the factors affecting virological failure.Improving patients’treatment compliance at an early stage by early detection of influencing factors,and strengthening the follow-up and management of patients are needed to improve the success rate of antiviral treatment for HIV/AIDS patients in Liangshan P

关 键 词：HIV/AIDS患者 抗病毒治疗效果 影响因素 

分 类 号：R512.91[医药卫生—内科学]