2013-2023年我国不同特征HIV/AIDS患者晚发现趋势分析  

Trend analysis of late presentation of patients with HIV/AIDS with different characteristics in China between 2013 and 2023

作　　者：杨忠念 陈勇军 汤后林[1] 秦倩倩[1] 费丽萍 王实 陈方方[1] 吕繁[1] YANG Zhongnian;CHEN Yongjun;TANG Houlin;QIN Qianqian;FEI Liping;WANG Shi;CHEN Fangfang;LYU Fan(National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases/National Center for AIDS/STD Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China;Institute of Blood Transfusion,Chinese Academy of Medical Sciences,Chengdu 610052,Sichuan,China)

机构地区：[1]传染病溯源预警与智能决策全国重点实验室/中国疾病预防控制中心性病艾滋病预防控制中心,北京102206 [2]中国医学科学院输血研究所,成都610052

出　　处：《中国艾滋病性病》2025年第1期17-23,共7页Chinese Journal of Aids & STD

基　　金：北京市自然科学基金-昌平创新联合基金资助项目(L234008)。

摘　　要：目的了解2013-2023年我国新报告HIV/AIDS患者晚发现趋势变化,为今后开展精准高效的艾滋病检测工作提供依据。方法从艾滋病综合防治信息系统中选取2013-2023年我国新报告确诊年龄≥18岁的HIV/AIDS患者为研究对象,将HIV确诊时首次CD4细胞计数<350个/μL或出现艾滋病定义性事件的患者定义为晚发现病例。采用Joinpoint回归模型对晚发现比例的时间趋势进行分析。结果2013-2023年我国HIV/AIDS患者的晚发现比例为60.56%,且呈上升趋势[平均年度变化百分比(AAPC)=1.09%,P<0.05]。其中,华北、华东、西南、西北地区的晚发现比例显著上升,西北地区上升速度最快(AAPC=2.83%,P<0.05),而华中地区则呈缓慢下降趋势(AAPC=-0.86%,P<0.05)。<50岁患者晚发现比例整体呈缓慢上升趋势(AAPC=0.89%,P<0.05),而≥50岁患者晚发现比例在64.24%~68.37%内波动,整体变化趋势无统计学意义(P>0.05)。经异性性传播者的晚发现比例高于经同性性传播者,但经同性性传播者晚发现比例上升速度更快(AAPC=1.16%vs.AAPC=0.85%)。研究期间,经医疗机构发现者的晚发现比例呈缓慢上升趋势(AAPC=0.69%,P<0.05),而VCT门诊发现者的晚发现比例整体变化趋势无统计学意义(AAPC=0.15%,P>0.05)。结论2013-2023年,我国HIV/AIDS患者晚发现比例处中等水平且呈缓慢上升趋势。其中,西北地区晚发现比例上升速度较快。≥50岁、经异性性传播患者晚发现比例总体水平较高,而经医疗机构发现患者晚发现比例上升趋势明显。Objective To analyze the trends in late presentation among patients with newly reported newly reported HIV/AIDS patients in China from 2013 to 2023.Methods Data were obtained from the National Comprehensive AIDS Prevention and Control Information System.This study included newly reported patients with HIV/AIDS aged≥18 years who were diagnosed between 2013 and 2023.Patients with an initial CD4 cell count<350 cells/μL or AIDS-defining events at diagnosis were defined as having a late presentation.A Joinpoint regression model was used to analyze temporal trends in the proportion of late presentations.Results Between 2013 and 2023,the overall proportion of late presentation among patients with HIV/AIDS in China will be 60.56%,showing an upward trend[average annual percentage change(AAPC)=1.09%,P<0.05].The proportion of late presentation significantly increased in the northern,eastern,southwestern,and northwestern regions,with the fastest growth observed in the northwestern region(AAPC=2.83%,P<0.05),whereas the central region showed a slight decline(AAPC=-0.86%,P<0.05).Among patients aged<50 years,the proportion with late presentation exhibited a slow upward trend(AAPC=0.89%,P<0.05).For those aged≥50 years,the proportion varied from 64.24%-68.37%,with no statistically significant overall trend(P>0.05).The proportion of late presentation was higher among patients infected via heterosexual transmission than among those infected via homosexual transmission.In contrast,the growth rate of late presentation was faster among cases of homosexual transmission cases(AAPC=1.16%vs.AAPC=0.85%).During the study period,late presentation among cases identified through medical institutions showed a gradual increase(AAPC=0.69%,P<0.05),whereas the trend among cases identified through voluntary counseling and testing clinics was not statistically significant(AAPC=0.15%,P>0.05).Conclusions Between 2013 and 2023,the proportion of late presentation among HIV/AIDS patients in China remained moderate and showed a slow upward trend.The no

关 键 词：艾滋病病毒感染者/艾滋病患者 晚发现 时间趋势 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]