北京市丰台区男男性行为人群不同转介模式人类免疫缺陷病毒/获得性免疫缺陷综合征抗病毒治疗免疫学效果分析  

Immunological efficacy of antiviral therapy by different referral modes among men who have sex with men with HIV/AIDS in Fengtai District of Beijing

作　　者：李彦奇[1] 肖丹朝 尚翠 司芬芬 史文雅[1] 任航 许京春[1] 王欣心[1] Li Yanqi;Xiao Danzhao;Shang Cui;Si Fenfen;Shi Wenya;Ren Hang;Xu Jingchun;Wang Xinxin(Department of STD AIDS Prevention and Control,Fengtai District Center for Disease Control and Prevention,Beijing 100071,China)

机构地区：[1]北京市丰台区疾病预防控制中心性病艾滋病防制科,100071

出　　处：《山西医药杂志》2023年第12期897-902,共6页Shanxi Medical Journal

基　　金：北京市丰台区卫生健康系统科研项目(2019-134)。

摘　　要：目的 分析北京市丰台区2018—2021年通过不同治疗转介模式开始艾滋病抗病毒治疗(ART)的男男性行为人群人类免疫缺陷病毒(HIV)/获得性免疫缺陷综合征(AIDS)治疗免疫学效果,并探讨其影响因素。方法 采用回顾性队列研究方法,利用艾滋病综合防治信息信息系统中2018—2021年通过一站式服务和其他机构转介2种模式进入队列的患者数据资料进行分析,采用χ^(2)检验和Mann-Whitney U检验比较不同治疗转介途径免疫学效果差异。采用Logistic回归模型分析抗病毒治疗免疫学效果的影响因素。结果 共纳入研究对象857例,其中一站式服务组589例(68.7%),其他机构组268例(31.3%)。一站式服务组确证后1个月开始ART的比例(89.5%)高于其他机构组(77.6%)(χ^(2)=21.23,P<0.01),基线处于世界卫生组织(WHO)期的比例(91.7%)高于其他机构组(85.1%)(χ^(2)=8.64,P<0.01)。一站式服务组随访第1年内CD4/CD8增幅高于其他机构组(Z=-2.85,P<0.01)。多因素logistics分析显示,MSM患者抗病毒治疗免疫学效果受年龄、随访状态、随访时间、初始治疗方案、基线CD4及基线CD4^(+)/CD8^(+)比值的影响。结论 社会组织与定点医院联合提供的检测治疗一站式服务在提高ART及时性、促进治疗效果方面发挥了积极的作用。Objective To analyze the immunological efficacy of antiviral therapy by different referral modes and its influencing factors among men who have sex with men with immunodeficiency virus/acquired immunodeficiency syndromes(HIV/AIDS)in Fengtai District of Beijing from 2018 to 2021.Methods A retrospective cohort study was conducted to analyze the data collected from National HIV/AIDS Information System referred by HIV/AIDS testing and treatment one-stop service and other case reporting institutions during 2018—2021,and the Mann-Whitney U test and chi-square test were used to compare the immunological effect between different referral modes while a logistic regression model was used to analyze factors of immunological efficacy of antiviral therapy.Results A total number of 857 cases were enrolled with 589 cases(68.7%)referred by HIV/AIDS testing and treatment one-stop service,and 268 cases(31.3%)referred by case reporting institutions.The one-stop-service group had a higher proportion(89.5%)of patients starting antiviral therapy within 1 month than the other institutions group(77.6%)(χ^(2)=21.23,P<0.01).The proportion of WHO AIDS clinical stageⅠin the One-stop-service group(91.7%)was higher than that in other institutions group(85.1%)(χ^(2)=8.64,P<0.01).The increase of CD4^(+)/CD8^(+)T cells ratio in the one-stop-service group was higher than that in other institutions group within the first year of follow-up(Z=-2.85,P<0.01).Multivariate Logistic analysis revealed that age,follow-up status,follow-up time,initial treatment regimen,baseline CD4^(+)T cells and CD4^(+)/CD8^(+)T cells ratio were the factors influencing the success of immunological effects.Conclusion The one-stop service of HIV testing and treatment has played an active role in improving the timeliness and effectiveness of anti-retroviral therapy.

关 键 词：获得性免疫缺陷综合征 性行为 同性恋 男性 抗病毒药 免疫 

分 类 号：R512.91[医药卫生—内科学]