广西HIV感染儿童接受抗病毒治疗、生存及影响因素分析  

Analysis of antiretroviral therapy,survival,and influencing factors among HIV-infected children in Guangxi

作　　者：谢昊珉 黄精华[1] 何芹[1] 唐凯玲 马洁 方宁烨[1] 梁淑家[1] 庞贤武[1] XIE Hao-min;HUANG Jing-hua;HE Qin;TANG Kai-ling;MA Jie;FANG Ning-ye;LIANG Shu-jia;PANG Xian-wu(Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention,Nanning,Guangxi 530028,China)

机构地区：[1]广西壮族自治区疾病预防控制中心,广西南宁530028

出　　处：《现代预防医学》2025年第3期455-459,共5页Modern Preventive Medicine

基　　金：广西自然科学基金(2024GXNSFAA010306)。

摘　　要：目的分析广西地区HIV感染儿童的抗逆转录病毒治疗情况、生存状况以及影响因素。方法本研究采用回顾性队列研究方法,纳入广西地区≤14岁HIV感染儿童的相关数据,包括治疗情况、生存时间和影响因素。采用logistic回归方法和Cox比例风险回归模型统计学分析方法对数据进行处理。结果研究共纳入472例HIV感染儿童,27例死亡,100%接受了抗逆转录病毒治疗。确诊后,年龄、临床分期等因素影响了确诊到开始治疗时间延长的风险。生存分析显示,治疗前基线CD4+T细胞水平、临床分期和治疗方案是影响儿童生存时间的关键因素。治疗前基线CD4+T细胞>350个/μl的儿童生存时间高于治疗前基线CD4+T细胞<200个/μl(aHR=0.31,95%CI:0.13~0.74);WHO临床分期为Ⅳ期的儿童生存时间低于Ⅰ期(aHR=3.22,95%CI:1.24~12.2);使用3TC+ABC+克力芝治疗方案的儿童生存时间低于使用3TC+AZT+EFV治疗方案(aHR=4.26,95%CI:1.16~15.61)。结论广西地区HIV感染儿童的抗逆转录病毒治疗覆盖率较高,生存率相对较好。然而,需要加强对患儿及其家长的宣传教育,尽早启动治疗,优化治疗方案,提高生存质量。Objective To analyze the status of antiretroviral therapy(ART),survival outcomes,and influencing factors among HIV-infected children in Guangxi.Methods A retrospective cohort study was conducted,incorporating data from HIV-infected children aged≤14 years in Guangxi,including treatment status,survival time,and influencing factors.Logistic regression and Cox proportional hazards regression models were employed for statistical analysis.Results A total of 472 HIV-infected children were included,with 27 deaths reported.All children received ART.Factors such as age and clinical stage at diagnosis influenced the risk of delayed initiation of treatment.Survival analysis revealed that baseline CD4+T-cell levels,clinical stage,and treatment regimen were key determinants of survival time.Children with baseline CD4+T-cell counts>350 cells/μL had longer survival time compared to those with counts<200 cells/μL(aHR=0.31,95%CI:0.13-0.74).Children in WHO clinical stage IV had shorter survival times than those in stage I(aHR=3.22,95%CI:1.24-12.2).Additionally,children treated with the 3TC+ABC+LPV/r regimen had shorter survival time than those treated with the 3TC+AZT+EFV regimen(aHR=4.26,95%CI:1.16-15.61).Conclusion The coverage of ART among HIV-infected children in Guangxi is high,with relatively favorable survival rates.However,efforts should be intensified to educate caregivers and initiate treatment early,optimize treatment regimens,and improve quality of life.

关 键 词：艾滋病 儿童 抗病毒治疗 生存分析 影响因素 

分 类 号：R512.91[医药卫生—内科学]