六安市抗病毒治疗HIV/AIDS患者低病毒血症发生情况及影响因素分析  

Incidence and influencing factors of low-level viraemia in HIV/AIDS patients treated with antiretroviral therapy in Lu'an City

作　　者：陈海燕[1] 马功燕[1] 陈栋[1] CHEN Haiyan;MA Gongyan;CHEN Dong(Lu'an Center for Disease Control and Prevention,Lu'an,Anhui 237000,China)

机构地区：[1]六安市疾病预防控制中心,安徽六安237000

出　　处：《华南预防医学》2024年第12期1109-1114,共6页South China Journal of Preventive Medicine

摘　　要：目的 分析六安市抗病毒治疗HIV/AIDS患者低病毒血症(LLV)发生影响因素,以及和病毒抑制失败(VF)的关联,为预防LLV的发生提供依据。方法 采用回顾性队列研究方法,从中国疾病预防控制信息系统下载六安市抗逆转录病毒治疗(ART)数据库,选取2006—2023年接受ART、年龄≥16岁、ART时长≥6个月的患者作为调查对象,对患者的人口学特征和ART情况进行描述性分析,采用logistic回归模型分析患者发生LLV的影响因素,Kaplan-Meier生存曲线分析LLV和VF的关联。结果 共纳入1 834例调查对象,LLV发生率为24.21%(444例),其中低水平LLV(LLLV)发生率为15.87%(291例),中等水平LLV(MLLV)发生率为4.20%(77例),高水平LLV(HLLV)发生率为4.14%(76例);不同水平LLV患者VF发生率比较差异有统计学意义(P<0.05);现治疗地区[金安区(OR=3.017)、叶集区(OR=3.075)、舒城县(OR=3.473)],感染途径[同性传播(OR=0.382)、异性传播(OR=0.504)],治疗过程中更换治疗方案(OR=1.854),基线CD4+T淋巴细胞计数<200个/μL(OR=1.642),治疗年限为1~5年(OR=0.660)是发生LLV的影响因素。结论 六安市HIV/AIDS患者LLV发生的风险较高,且会增加VF发生的风险。基线CD4+T淋巴细胞计数<200个/μL、治疗过程中更换方案等是LLV发生的危险因素,应尽早进行规范抗病毒治疗,同时提高患者治疗管理质量。Objective To analyze the influencing factors of low-level viraemia(LLV)and its relationship with vi‑rus inhibition failure(VF)in HIV/AIDS patients undergoing antiretroviral therapy(ART)in Lu'an City,and to provide the evidence for the prevention of LLV.Methods A retrospective cohort study design was utilized,the ART database of the Lu'an City was obtained from the China Disease Control and Prevention Information System.HIV/AIDS patients who under‑went ART,aged≥16 years,and had an ART duration≥6 months between 2006 and 2023 were selected as the study sub‑jects.Descriptive analysis was used to examine demographic characteristics and ART status,while a logistic regression model was employed to analyze the influencing factors of LLV.Additionally,a Kaplan-Meier survival curve was utilized to assess the association between LLV and VF.Results A total of 1834 respondents were included in the analysis.The inci‑dence of LLV was found to be 24.21%(444 cases),comprising 15.87%(291 cases)with low-level LLV(LLLV),4.20%(77 cases)with medium-level LLV(MLLV),and 4.14%(76 cases)with high-level LLV(HLLV).There was a statistically sig‑nificant difference in the incidence of VF for LLVs at different levels(P<0.05).The influencing factors of LLV included the current treatment area(Jin'an District OR=3.017,Yeji District OR=3.075,Shucheng County OR=3.473),route of infection(homosexual transmission OR=0.382,heterosexual transmission OR=0.504),change in treatment scheme(OR=1.854),baseline CD4+T lymphocyte count<200/μL(OR=1.642),as well as treatment duration being 1-5 years(OR=0.660).Conclusions There is a high risk for LLV in HIV/AIDS patients in Lu'an City,which increases their risk for VF.The risk factors identified include baseline CD4+T lymphocyte count<200/μL,changing treatment schemes,among others.It is nec‑essary to start ART as earlier as possible and improve the quality of treatment management of patients.

关 键 词：HIV/AIDS患者 低病毒血症 病毒抑制失败 影响因素 

分 类 号：R183.7[医药卫生—流行病学]