2018-2023年中国HIV感染者启动抗病毒治疗前的血脂异常特征及影响因素分析  

Prevalence of dyslipidemia and influencing factors in HIV-infected people before starting antiretroviral therapy in China,2018-2023

作　　者：贾瀚璐 魏来 耿云霞 甘秀敏[1] 赵德才[1] 赵燕[1] Jia Hanlu;Wei Lai;Geng Yunxia;Gan Xiumin;Zhao Decai;Zhao Yan(Division of Treatment and Care,National Center for AIDS/STD Control and Prevention,Chinese Center for Disease Control and Prevention,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治疗与关怀室,北京102206

出　　处：《中华流行病学杂志》2025年第1期95-100,共6页Chinese Journal of Epidemiology

摘　　要：目的了解全国HIV感染者启动抗病毒治疗(ART)前的血脂异常特征。方法资料来源于中国疾病预防控制信息系统艾滋病ART数据库,以全国2018-2023年启动ART的HIV感染者为研究样本,收集研究对象启动ART的基线信息,包括社会人口学和实验室检查等信息,依据《中国血脂管理指南(2023)》和美国国家胆固醇教育计划成年人治疗小组Ⅲ准则将TG≥1.7 mmol/L或TC≥5.2 mmol/L定义为血脂异常。应用SAS 9.4软件进行统计学分析,采用非条件logistic回归模型分析启动ART前的HIV感染者TG和TC异常的影响因素。结果在359952例HIV感染者中,血脂异常率为38.41%(138263/359952)。TG和TC的异常率分别是31.40%(113041/359952)和13.75%(49494/359952)。在25~44岁年龄组之外的其他各年龄组中,女性HIV感染者的TG和TC异常率均高于男性。女性、45~64岁、东北地区、传播途径为异性性传播、BMI≥28.0 kg/m^(2)、CD4^(+)T淋巴细胞计数≥500个/µl的HIV感染者基线血脂异常率较高(均P<0.05)。结论2018-2023年我国HIV感染者启动ART前的TG异常率较高,尤其是女性HIV感染者,且随着年龄上升,TG和TC异常率均上升,在临床诊疗及选择ART方案时要予以重视。Objective To investigate the prevalence of baseline dyslipidemia in HIV-infected people before starting antiviral therapy(ART)in China.MethodsThe data were collected from HIV/AIDS ART database of Chinese Disease Prevention and Control Information System.A national sample of HIV-infected people who initiated ART from^(2)018 to 2023 was used to collect baseline information,including sociodemographic characteristics and laboratory test results.According to the Chinese Lipid Management Guidelines(2023)and the National Cholesterol Education Program Adult Treatment PanelⅢguidelines,triglyceride(TG)≥1.7 mmol/L or total cholesterol(TC)≥5.2 mmol/L were identified as dyslipidemia.Statistical analysis was performed with software SAS 9.4.An unconditional logistic regression model was used to analyze the factors influencing TG and TC abnormalities in HIV-infected patients before ART.ResultsA total of 359952 adults infected with HIV were included in this study,the prevalence rate of dyslipidemia was 38.41%(138263/359952).The abnormal rates of TG and TC were 31.40%(113041/359952)and 13.75%(49494/359952),respectively.In all age groups except for the 25-44 age groups,the abnormal rates of TG and TC were higher in HIV-infected women than in HIV-infected men.In HIV-infected patients,women,those aged 45-64 years,those lived in northeast region,those had heterosexual transmission,and those with BMI≥28.0 kg/m^(2),CD4^(+)T lymphocytes counts≥500 cells/µl had higher rates of baseline dyslipidemia(all P<0.05).ConclusionsThe abnormal rate of TG in HIV-infected people before ART was higher in China from^(2)018 to 2023,especially in HIV-infected women,and the abnormal rate of TG and TC increased with age.Attention should be paid to the clinical diagnosis and ART selection in the treatment of HIV infection.

关 键 词：艾滋病病毒 抗病毒治疗 三酰甘油 总胆固醇 血脂异常 

分 类 号：R51[医药卫生—内科学]