云南省2004~2022年经母婴传播HIV感染儿童抗病毒治疗效果评价及影响因素分析  

Evaluation of the effectiveness of antiretroviral therapy on mother-to-child transmission of HIV in children in Yunnan Province,2004-2022 and analysis of influencing factors

作　　者：王海洋 刘恒丽 张双梅 楼金成 张娅玲 杨翠先 张欢欢 李侠 WANG Hai-yang;LIU Heng-li;ZHANG Shuang-mei(School of Public Health,Dali University,Dali 671000,China)

机构地区：[1]大理大学公共卫生学院,671000 [2]云南省传染病医院感染一科,650301 [3]云南省传染病医院滋病临床管理办公室,650301 [4]云南省传染病医院检验科,650301

出　　处：《中国实用医药》2024年第6期164-169,共6页China Practical Medicine

基　　金：云南省科技厅科技计划项目云南省感染性疾病(艾滋病)临床医学研究中心(项目编号:202102AA310005);云南省传染病医院李太生专家工作站项目(项目编号:20105AF150023)。

摘　　要：目的 探讨云南省2004~2022年经母婴传播人类免疫缺陷病毒(HIV)感染儿童抗病毒治疗效果及影响因素,为提高疗效提供参考。方法 收集云南省经母婴传播HIV感染儿童抗病毒治疗资料,采用描述性流行病学方法 ,分析抗逆转录病毒疗法(ART)治疗HIV感染患儿的基本特征、不同年份启动ART治疗儿童数量和年龄分布情况;用多元Logistics回归分析ART疗效的影响因素。结果 新入组接受ART治疗的患儿数量自2004年起随年份的增长呈上升趋势, 2013年后逐年下降。截止2022年8月全省1451例在治患儿中,男性占48.45%;目前年龄16.4(12.8, 18.7)岁;开始ART年龄7.0(4.2, 9.8)岁;已接受ART治疗时间8.6(5.5, 10.8)年;确诊HIV/艾滋病(AIDS)到启动ART间隔时间5.1(0.7, 29.5)个月;病毒完全抑制率为68.16%(989/1451), ART治疗失败率为20.68%(300/1451)。单因素分析显示:ART疗效的影响因素有开始ART年龄、已接受ART治疗时间、确诊HIV/AIDS到启动ART间隔时间、目前ART方案、是否更换过ART方案(P<0.05)。以单因素分析中差异有统计学意义的因素作为自变量,进行多因素Logistic回归分析,结果显示:ART疗效的影响因素为已接受ART治疗时间、确诊HIV/AIDS到启动ART间隔时间、目前ART方案、是否更换过ART方案(P<0.05)。结论 应以早发现、早治疗、规范治疗和提高儿童患儿依从性为重点,特别关注学龄期儿童以及更换过治疗方案的患儿,是进一步提高患儿ART疗效的关键。Objective To investigate the efficacy and influencing factors of antiretroviral therapy in children who with mother-to-child transmission of human immunodeficiency virus(HIV)in Yunnan Province,and to provide a reference for improving the efficacy.Methods The antiretroviral therapy data of HIV children who infected with mother-to-child transmission in Yunnan province were collected.Descriptive epidemiological methods were used to analyze the basic characteristics of children treated with antiretroviral therapy(ART)for HIV infection,as well as the number and age distribution of children who started ART in different years.The factors influencing the efficacy of ART were analyzed by multivariate logistic regression.Results The number of children with initiation of ART has increased since 2004,and has decreased year by year since 2013.By August 2022,among the 1451 children under treatment in the province,48.45%were male;with current age of 16.4(12.8,18.7)years,age of initiation of ART of 7.0(4.2,9.8)years,8.6(5.5,10.8)years on ART;the interval between diagnosis of HIV/acquired immune deficiency syndrome(AIDS)and initiation of ART was 5.1(0.7,29.5)months;the complete suppression rate of HIV-RNA was 68.16%(989/1451),and the rate of ART failure was 20.68%(300/1451).Univariate analysis showed that the factors influencing ART efficacy were age at ART initiation,time already on ART,time between diagnosis of HIV/AIDS and initiation of ART,current ART regimen,and whether or not the ART regimen had been changed(P<0.05).Multivariate Logistic regression analysis was conducted with the factors with statistical significance in the univariate analysis as independent variables,and the results showed that the influencing factors of ART efficacy were time already on ART,time between diagnosis of HIV/AIDS and initiation of ART,current ART regimen,and whether or not the ART regimen had been changed(P<0.05).Multivariate analysis showed that the influencing factors of HIV-RNA suppression effect were age of initiation of ART,years on treat

关 键 词：人类免疫缺陷病毒 艾滋病 抗病毒治疗 母婴传播 效果评估 

分 类 号：R725.1[医药卫生—儿科]