四川省新报告HIV单阳家庭抗病毒治疗及时性及影响因素分析  

Timeliness and influencing factors of receiving antiretroviral therapy among newly reported discordant couples in Sichuan Province

作　　者：李菊梅 高鑫 殷鑫杰 马瑞 任建华 杨薇[1] 喻航[1] 张晓玲 杨一挥[1] LI Jumei;GAO Xin;YIN Xinjie;MA Rui;REN Jianhua;YANG Wei;YU Hang;ZHANG Xiaoling;YANG Yihui(Sihuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan,China)

机构地区：[1]四川省疾病预防控制中心,成都610041

出　　处：《中国艾滋病性病》2024年第10期1030-1035,共6页Chinese Journal of Aids & STD

基　　金：四川省疾病预防控制中心自立科研课题(ZX202015);四川省高等学校人文社会科学重点研究基地四川省儿童保护与发展中心课题(ETBH2022-ZD001)。

摘　　要：目的了解四川省新报告HIV单阳家庭启动cART的时间与及时性,并分析及时性影响因素。方法选取艾滋病综合防治信息系统现住址为四川省且新诊断HIV单阳家庭作为研究对象。采用SPSS23.0进行χ2检验分析和多因素非条件Logistic回归分析。结果符合条件的新确诊HIV单阳家庭阳性方共3705例,cART启动治疗的中位时间为11 d,0 d、2~7 d、8~14 d、15~30 d、31~180 d、181~365 d、366 d及以上启动cART分别为0.57%(21例)、32.85%(1217例)、33.36%(1236例)、21.89%(811例)、10.28%(381例)、0.84%(31例)和0.22%(8例)。30 d内启动cART比例为88.66%(3285例)。多因素Logistic回归分析显示,相较于男性、治疗前基线CD4淋巴细胞<200个/μL的HIV感染者,女性(OR=1.492,95CI%:1.139~1.953)、治疗前基线CD4淋巴细胞200~349个/μL(OR=1.498,95%CI:1.119~2.005)以及350~499个/μL(OR=1.472,95%CI:1.044~2.076)及时启动cART的概率更高;相较于汉族、县内流动、原阳方确诊至最早配偶检测时间≤30 d的HIV感染者,彝族(OR=0.440,95%CI:0.325~0.596)、其他少数民族(OR=0.400,95%CI:0.196~0.815)、市内跨县区流动(OR=0.543,95%CI:0.412~0.717)、省内跨市州流动(OR=0.420,95%CI:0.294~0.600)、跨省流动(OR=0.189,95%CI:0.127~0.282)、原阳方确诊至最早配偶检测时间31~180 d(OR=0.205,95%CI:0.159~0.263)及>180 d(OR=0.251,95%CI:0.183~0.344)及时启动cART的概率更低。结论四川省新报告HIV单阳家庭及时启动cART比例较高,加强男性、少数民族、晚发现、异地报告以及未及时完成配偶检测病例的治疗转介。Objective To comprehend the timeliness of initiation of combined antiretroviral therapy(cART)initiation among newly reported HIV discordant couples in Sichuan Province,and to analyze factors influencing timeliness.Methods Subjects were newly diagnosed HIV discordant couples with current residence in Sichuan Province,selected from the Comprehensive AIDS Prevention and Control Information System.Statistical analysis was performed using SPSS 23.0 with Chi-square tests and multivariate unconditional logistic regression.Results Among a total of 3705 eligible newly diagnosed HIV discordant cases,the median time to cART initiation was 11 days.The proportions of initiation at 0 days,2-7 days,8-14 days,15-30 days,31-180 days,181-365 days,and over 366 days were 0.57%(21cases),32.85%(1217 cases),33.36%(1236 cases),21.89%(811 cases),10.28%(381 cases),0.84%(31 cases),and 0.22%(8 cases),respectively.The proportion of cART initiation within 30 days was 88.66%(3285 cases).Multivariate logistic regression analysis revealed that,compared with men and HIV-infected individuals with baseline CD4 lymphocyte count<200 cells/μL,the likelihoods of timely cART initiation were higher in women(OR=1.492,95%CI:1.139-1.953),individuals with baseline CD4 counts of 200-349 cells/μL(OR=1.498,95%CI:1.119-2.005),and 350-499 cells/μL(OR=1.472,95%CI:1.044-2.076).Conversely,Yi ethnicity(OR=0.440,95%CI:0.325-0.596),other ethnic minorities(OR=0.400,95%CI:0.196-0.815),intra-city and inter-county mobility(OR=0.543,95%CI:0.412-0.717),intra-provincial and inter-city(prefecture)mobility(OR=0.420,95%CI:0.294-0.600),inter-provincial mobility(OR=0.189,95%CI:0.127-0.282),and time from initial positive diagnosis to earliest spouse testing of 31–180 days(OR=0.205,95%CI:0.159-0.263)and>180 days(OR=0.251,95%CI:0.183-0.344)were associated with lower probabilities of timely c ART initiation.Conclusions In Sichuan Province,the proportion of newly reported HIV discordant relationships promptly initiating c ART is promptly high.Enhancements in the treatment referral

关 键 词：艾滋病病毒 单阳家庭 抗病毒治疗 及时性 影响因素 

分 类 号：R373.9[医药卫生—病原生物学]