我国2016-2020年新报告HIV感染者跨省流动情况对启动抗病毒治疗的影响分析  

The impact of cross provincial migration on the initiation of antiviral therapy among newly reported HIV infected persons in China from 2016 to 2020

作　　者：吕婉婷 赵燕[1] 殷文婷 刘毅 韩孟杰[1] LYU Wanting;ZHAO Yan;YIN Wenting;LIU Yi;HAN Mengjie(National Center for STD/AIDS Prevention and Control,China CDC,Beijing 102206,China)

机构地区：[1]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：《中国艾滋病性病》2023年第4期388-391,共4页Chinese Journal of Aids & STD

摘　　要：目的 分析2016-2020年新报告HIV感染者一年内启动ART前发生跨省流动和启动ART情况,了解启动ART前发生流动对启动ART的影响。方法 利用全国艾滋病防治基本信息系统报告数据,采用描述性分析、χ^(2)检验,采用Cox回归分析探讨一年内启动抗病毒治疗的危险因素,并通过绘制生存曲线及计算四分位数的方法,分析治疗前发生流动情况对启动ART的影响情况。结果 2016-2020年我国新报告HIV感染者一年内启动治疗率为84.02%(551 479/656 354),2016-2020年新报告HIV感染者一年内治疗率逐年提升,分别为75.24%(87 489/116 276),79.78%(101 505/127 225),85.27%(120 105/140 847),88.58%(128 624/145 203),89.71%(113 756/126 803)。新报告HIV感染者一年内首次随访后发生跨省流动率为2.87%(18 852/656 354)。跨省流动的感染者中治疗前发生流动的占52.70%(9 935/18 852)。多因素Cox回归分析发现,治疗前是否发生流动、年龄、性别、民族、婚姻状况、文化程度、感染途径、治疗前CD4细胞检测结果是影响新报告HIV感染者一年内启动ART的因素。治疗前发生流动的感染者的启动治疗时间(中位启动治疗时间207天)长于未流动的感染者(中位启动治疗时间20天)。结论 HIV感染者一年内启动ART的时间间隔和一年内启动治疗比例与治疗前是否发生流动有关。建议关注治疗前发生流动的HIV感染者,加强后续随访,做好转介衔接,使流动HIV感染者尽早启动ART。Objective To analyze the cross provincial migration and ART initiation of the newly reported HIVinfected individuals within one year before initiating ART from 2016 to 2020, and understand the impact of pre-initiation migration on ART initiation. Methods The risk factors of initiating antiretroviral therapy within one year were explored by descriptive analysis, chi-square test, and Cox regression analysis was used to explore the risk factors for initiating antiretroviral therapy within one year. The survival curve and quartile calculation were plotted to analyze the influence of pre-treatment flow on ART. Results From 2016 to 2020, the rate of ART initiation within one year among newly reported HIV/AIDS cases was 84.02%(551479/656354) in China. The treatment proportion was increasing from 75.24%(87489/116276) in 2016,79.78%(101505/127225) in 2017,85.27%(120105/140847) in 2018, 88.58%(128624/145203) in 2019 and 89.71%(113756/126803)in 2020. The cross provincial mobility rate among newly reported HIV/AIDS within one year after the first follow-up was 2.87%(18852/656354). 52.70%(9935/18852) of the patients who had cross provincial mobility moved before ART initiation. Multivariate Cox regression analysis found that pre-treatment mobility,age, gender, ethnicity, marital status, educational level, route of infection and pre-treatment CD4 test result were the factors associated with the initiation of ART in newly reported patients within one year. The median time to start ART was 207 days for those who mobilized before ART initiation which was longer than those who did not mobile before ART(median 20 days). Conclusions The time interval and proportion of people with ART initiation within one year after the first follow-up were associated with whether they mobilized or not before ART. It is recommended to pay attention to migrating HIV-infected patients before ART by strengthening information sharing, improving referral services provision,and encouraging of HIV infected patients to start ART as soon as possible.

关 键 词：艾滋病 流动人口 抗病毒治疗 

分 类 号：R373.9[医药卫生—病原生物学]