2016-2022年宜昌市新报告HIV/AIDS病例抗病毒治疗及时性分析  

Timeliness of antiviral therapy for newly reported HIV/AIDS cases in Yichang City in 2016-2022

作　　者：闵洁 赵丁源[2] 张皓[1] 雷雯[1] 田雨[1] 李芳芳 MIN Jie;ZHAO Dingyuan;ZHANG Hao;LEI Wen;TIAN Yu;LI Fangfang(Yichang Municipal Center for Disease Control and Prevention,Yichang,Hubei 443000,China;Hubei Provincial Center for Disease Control and Prevention,Wuhan,Hubei 430079,China)

机构地区：[1]湖北省宜昌市疾病预防控制中心,湖北宜昌443000 [2]湖北省疾病预防控制中心,湖北武汉430079

出　　处：《公共卫生与预防医学》2024年第5期117-120,共4页Journal of Public Health and Preventive Medicine

基　　金：湖北省重点研发计划项目(2021BCA148);2022年宜昌市科技创新医疗卫生项目(A22-2-077)。

摘　　要：目的了解2016—2022年宜昌市新报告HIV/AIDS病例ART及时性情况及其影响因素,为提高宜昌市ART及时性提供科学依据。方法收集2016年1月1日至2022年12月31日的HIV/AIDS病例数据,采用χ^(2)检验和logistics回归分析ART及时性影响因素。结果共收集HIV/AIDS病例1126例,本地报告病例占83.13%;男女性别比5.15∶1;中位年龄42岁(28~53岁);未婚占41.03%;首次CD4+T淋巴细胞(简称CD4细胞)计数<200个/μL的病例占38.99%;首次CD4细胞检测及时病例占67.85%。2016—2022年总体ART及时率57.19%,从确诊到启动ART中位时间为20 d,2016—2022年ART及时率的变化趋势差异无统计学意义(P=0.251)。首次CD4细胞检测及时病例(OR=3.831,95%CI:2.454~5.981)更容易及时启动ART;外地报告病例(OR=0.497,95%CI:0.345~0.716)和首次CD4细胞计数水平越高的病例(OR≥500=0.473,95%CI:0.312~0.718)更不易及时启动ART。结论宜昌市抗病毒治疗及时率有待进一步提高,应高度关注外地报告、CD4细胞检测不及时和CD4细胞计数水平较高病例,做好治疗动员和转介,及时提供早期检测服务。Objective To understand the timeliness of antiretroviral therapy(ART)in newly reported HIV/AIDS cases in Yichang from 2016 to 2022 and its influencing factors,and to provide a scientific basis for improving the timeliness of ART in Yichang City.Methods HIV/AIDS cases data from January 1,2016 to December 31,2022 were collected,and chi-square tests and logistic regression were used to analyze the factors influencing the timeliness of ART.Results A total of 1126 HIV/AIDS cases were collected,with local reported cases accounting for 83.13%.The male to female ratio was 5.15∶1.The median age was 42 years old(28-53 years old).41.03%of the cases were unmarried.38.99%of cases had a first-time CD4+T lymphocytes(CD4 cells)count<200 cells/μL.Cases with timely first CD4 cell test accounted for 67.85%.The overall timely rate of ART from 2016 to 2022 was 57.19%,with a median time from diagnosis to initiation of ART of 20 days.There was no statistically significant difference in the trend of ART timely rate from 2016 to 2022(P=0.251).Cases with timely first CD4 cell test were more likely to initiate ART in time(OR=3.831,95%CI:2.454-5.981),while cases reported from other areas(OR=0.497,95%CI:0.345-0.716)and cases with higher first CD4 cell count levels(OR_(≥500)=0.473,95%CI:0.312-0.718)were less likely to initiate ART in time.Conclusion The timely rate of antiviral treatment in Yichang City needs to be further improved.High attention should be paid to cases reported from other places,cases with delayed CD4 cell testing,and cases with high CD4 cell count levels.Treatment mobilization and referral should be done well,and early detection services should be provided in time.

关 键 词：HIV/AIDS 抗病毒治疗 及时性 

分 类 号：R181[医药卫生—流行病学]