2003—2020年北京某医院HIV/AIDS患者特点变化及延迟治疗影响因素  

Characteristics and changing trend of HIV/AIDS patients receiving early antiretroviral treatment in a hospital in Beijing,2003-2020

作　　者：陈美玲 段毓姣 许雅莉 万钢[1] 张福杰[1] CHEN Meiling;DUAN Yujiao;XU Yali;WAN Gang;ZHANG Fujie(Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院,100015

出　　处：《首都公共卫生》2024年第6期368-372,共5页Capital Journal of Public Health

摘　　要：目的探讨北京某医院接受抗反转录病毒治疗(anti-retroviral therapy,ART)的HIV/AIDS患者特征的变化趋势、ART及时性及其影响因素。方法回顾性分析2003—2020年在该院开始ART患者的一般人口学特征、流行病学特征及其ART情况。运用Excel 2021、SPSS 26.0软件对数据进行整理分析,统计方法包括χ^(2)检验、χ_(趋势)^(2)检验及logistic回归。结果研究共纳入患者10236例,男性比例呈逐年上升趋势(P<0.001),开始治疗年龄<45岁比例变化不明显,同性性传播感染比例逐年上升(P<0.001),非京籍患者比例明显增加(P<0.001)。基线病毒载量检测率在25.9%~95.8%间,确诊后3个月内开始治疗率在41.3%~88.7%间。基线病毒载量检测率、确诊后及时治疗率均逐年上升(P<0.001)。经多因素分析,延迟治疗的危险因素包括BMI≥18.5 kg/m2、同性性传播感染、输血/静脉吸毒感染、开始治疗时年龄<45岁和基线CD4细胞计数≥350个/μL。结论在该院接受ART的HIV/AIDS患者中年轻男性患者比例上升,基线CD4细胞检测、基线病毒载量检测率及确诊后及时治疗率逐年升高,应继续加强对未及时治疗的患者宣教动员及转介。Objective To explore the trends in characteristics,timeliness of anti-retroviral therapy(ART),and related determinants among HIV/AIDS patients receiving ART at a hospital in Beijing.Methods A retrospective analysis was conducted on the general demographic characteristics,epidemiological characteristics,and antiviral treatment status of patients receiving ART at this hospital from 2003 to 2020.Data were processed and analyzed using Excel 2021 and SPSS 26.0 software,with statistical method including chi-square test,chi-square trend testing,and logistic regression.Results A total of 10236 patients were included in the study.The proportion of male patients showed an upward trend year by year(P<0.001).The age at initiation of treatment had no significant change.The proportion of homosexual sexually transmission increased significantly annually,and the proportion of non-Beijing residents also increased significantly(P<0.001).The baseline viral load detection rate ranged from 25.9%to 95.8%,and the timely treatment initiation rate ranged from 41.3%to 88.7%.The rate of viral load detection at baseline and the rate of timely treatment increased significantly annually(P<0.001).Multivariate analysis showed that risk factors for delayed treatment included BMI≥18.5 kg/m^(2),homosexual sexually transmission,blood transfusion/injection drug use,age<45 years at the initiation of treatment,and baseline CD4 cell count≥350 cells/μL.Conclusions Among HIV/AIDS patients receiving ART at this hospital,the proportion of young male patients is increasing,and the rates of baseline CD4 cell testing,baseline viral load testing,and timely treatment after diagnosis are all improving annually.Further efforts are needed to strengthen education,mobilization,and referral for patients who have not received timely treatment.

关 键 词：HIV感染 抗病毒治疗 特征分布 变化趋势 

分 类 号：R512.91[医药卫生—内科学]