安徽省接受抗病毒治疗HIV/AIDS死亡的影响因素  

Influencing factors on the death of HIV/AIDS patients receiving antiretroviral therapy in Anhui Province

作　　者：戴色莺[1,2] 刘爱文[1,2] 沈月兰[1,2] 程晓莉[1,2] 张进[1,2] 吴建军[1,2] 吴家兵[1,2] 邢辉[3] 阮玉华[3] DAI Se-ying;LIU Ai-wen;SHEN Yue-lan;CHENG Xiao-li;ZHANG Jin;WU Jian-jun;WU Jia-bin;XING Hui;RUAN Yu-hua(Department of AIDS prevention,Anhui Provincial Center for Disease Control and Prevention,Hefei 230601,China;Center Laboratory of HIV Molecular and Immunology,Anhui Provincial Center for Disease Control and Prevention,Hefei 230601,China;National Center for AIDS/STD Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China)

机构地区：[1]安徽省疾病预防控制中心艾滋病防治科,合肥230601 [2]安徽省疾病预防控制中心艾滋病病毒分子与免疫学中心实验室,合肥230601 [3]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206

出　　处：《中华疾病控制杂志》2022年第12期1379-1383,1401,共6页Chinese Journal of Disease Control & Prevention

基　　金：国家科技重大专项(2017ZX10201101)。

摘　　要：目的 了解安徽省接受抗病毒治疗HIV感染者和AIDS病人(简称HIV/AIDS)死亡的影响因素。方法 采用1∶2匹配病例对照研究方法,回顾性收集2010―2019年安徽省接受抗病毒治疗HIV/AIDS的相关信息,采用条件logistic回归分析模型分析HIV/AIDS死亡的影响因素。结果 共调查4 347例HIV/AIDS,其中死亡组1 449例,对照组2 898例。多因素条件logistic回归分析模型分析显示,影响抗病毒治疗HIV/AIDS死亡的危险因素中,发生耐药、最近一次病毒载量≥1 000 copies/mL且未检测耐药、最近一次病毒载量无结果且未检测耐药分别是不耐药的1.75倍(95%CI:1.22~2.52,P=0.003)、2.26倍(95%CI:1.69~3.03,P<0.001)、35.27倍(95%CI:26.54~46.87,P<0.001);30~50岁和≥50岁分别是18~30岁的1.40倍(95%CI:1.01~1.94,P=0.042)和4.02倍(95%CI:2.80~5.77,P<0.001);男性是女性的1.37倍(95%CI:1.08~1.74,P=0.011);注射吸毒传播途径是异性传播途径的6.27倍(95%CI:2.00~19.61,P=0.002);治疗前WHO临床分期为Ⅲ期/Ⅳ期是Ⅰ期/Ⅱ期的1.41倍(95%CI:1.12~1.76,P=0.007);治疗前CD4+T淋巴细胞计数<200个/μL是≥350个/μL的1.95倍(95%CI:1.50~2.54,P<0.001)。结论 耐药、耐药检测、年龄、性别、传播途径、治疗前WHO临床分期、治疗前CD4+T淋巴细胞计数是安徽省接受抗病毒治疗HIV/AIDS发生死亡的影响因素。加强HIV/AIDS的耐药监测对减少艾滋病死亡具有重要意义,应对接受抗病毒治疗的HIV/AIDS及时进行病毒载量和耐药检测。Objective To understand the influencing factors on the death of HIV/AIDS patients receiving antiretroviral therapy in Anhui Province. Methods A 1 to 2 matched case-control study was conducted to collect the information of HIV/AIDS patients who received antiretroviral therapy in Anhui Province from 2010 to 2019. The conditional logistic regression was used to analyze the risk factors on the death of HIV/AIDS patients. Results A total of 4 347 HIV/AIDS patients were investigated, with 1 449 cases in the death group and 2 898 cases in the control group. The multivariate conditional logistic regression result showed that among the death risk factors, drug resistance was 1.75 times(95% CI: 1.22-2.52, P=0.003) than that of non-drug resistance;the latest viral load ≥1 000 copies/mL and non-drug resistance tested results were 2.26 times(95% CI: 1.69-3.03, P<0.001) than that of non-drug resistance;non-viral load and non-drug resistance tested results were 35.27 times(95% CI: 26.54-46.87, P<0.001) than that of non-drug resistance;patients who age 30-49 years old was 1.40 times(95% CI: 1.01-1.94, P=0.042) than that of the 18-29 years old, and those age ≥ 50 years old was 4.02 times(95% CI: 2.80-5.77, P<0.001) that of 18-29 years old;male was 1.37 times(95% CI: 1.08-1.74, P=0.011) than that of female, the transmission route of injecting drug use was 6.27 times(95% CI: 2.00-19.61, P=0.002) than that of heterosexual transmission;WHO clinical stage III/IV before treatment was 1.41 times(95% CI: 1.12-1.76, P=0.007) than that of stage I/II;CD4+T lymphocyte count <200 cells/μL before treatment was 1.95 times(95% CI: 1.50-2.54, P<0.001) that of CD4+≥350 cells/μL before treatment. Conclusions Drug resistance, drug resistance test after antiretroviral therapy, age, gender, transmission route, WHO clinical stage before treatment, and CD4+T lymphocyte counts before treatment were the influencing factors of HIV/AIDS death in Anhui Province. Strengthening the monitoring of drug resistance for HIV/AIDS patients is important for re

关 键 词：艾滋病病毒 死亡 影响因素 病例对照研究 

分 类 号：R512.91[医药卫生—内科学]