2014—2023年合肥市HIV/AIDS患者晚发现情况  

Analysis on the"late diagnosis"phenomena among newly identified human immunodeficiency virus/acquired immunodeficiency syndrome cases in Hefei,2014-2023

作　　者：董婷丽 姚晖[1] 邓晓岚[1] 朱国新 冯金保[1] 陈超杰[1] 吴萌 张卓 DONG Tingli;YAO Hui;DENG Xiaolan;ZHU Guoxin;FENG Jinbao;CHEN Chaojie;WU Meng;ZAHNG Zhuo(Hefei Center for Disease Control and Prevention,AIDS/STD Prevention Department,Hefei 230091,China)

机构地区：[1]合肥市疾病预防控制中心艾滋病性病防治科,合肥230091

出　　处：《中华疾病控制杂志》2025年第3期275-282,共8页Chinese Journal of Disease Control & Prevention

摘　　要：目的分析2014—2023年合肥市人类免疫缺陷病毒(human immunodeficiency virus,HIV)/艾滋病(acquired immunodeficiency syndrome,AIDS)患者特征,探究晚发现相关影响因素。方法从AIDS综合防治信息系统中选择2014—2023年新发现的HIV/AIDS病例,按照目前我国使用的晚发现定义标准,采用logistic回归分析模型分析晚发现情况与相关影响因素的关系。结果2014—2023年合肥市HIV/AIDS患者晚发现数为1218例,晚发现比例为34.18%(1218/3564),其中医疗机构检测晚发现占58.13%(708/1218),检测咨询占36.21%(441/1218)。晚发现患者中,以汉族为主,男性占90.97%,平均年龄为(42.15±14.22)岁。年龄组、婚姻状况、人口性质、文化程度、职业、传播途径、样本来源、区(县)、确诊到CD4+T淋巴细胞(简称CD4)检测时间变量组间分布差异均有统计学意义(均P<0.05)。多因素logistic回归分析模型分析结果显示,与<25岁年龄组相比,年龄越大,晚发现的风险越高。与小学及以下文化程度者相比,大专及以上者晚发现的风险更低(OR=0.70,95%CI:0.51~0.95,P=0.020)。与医疗机构检测来源相比,检测咨询(OR=0.45,95%CI:0.38~0.53)、阳性配偶/性伴检测(OR=0.31,95%CI:0.14~0.67)、羁押人员检测(OR=0.50,95%CI:0.29~0.86)、无偿献血人员检测(OR=0.35,95%CI:0.20~0.62)、其他检测(OR=0.50,95%CI:0.28~0.90)HIV/AIDS患者晚发现风险更低(均P<0.05)。与病例确诊到CD4检测时间间隔<15 d相比,确诊到CD4检测时间≥15 d HIV/AIDS患者晚发现风险较低。与有性病史者相比,性病史不详者HIV/AIDS患者晚发现风险更低(OR=0.61,95%CI:0.40~0.94,P=0.024)。结论2014—2023年合肥市HIV/AIDS晚发现病例数总体呈下降趋势,但医疗机构检测来源晚发现率仍较高。应进一步加强宣传教育力度,促进高危和老年人群开展早期检测,继续在医疗机构推行医疗机构医务人员主动提供检测与咨询策略,以及推进重点科室常规AIDS检测。Objective The characteristics of human immunodeficiency virus(HIV)-infected and acquired immunodeficiency syndrome(AIDS)patients in Hefei from 2014 to 2023 were analyzed to explore the relevant influencing factors of late diagnosis.Methods The newly discovered HIV/AIDS cases from 2014 to 2023 were selected from the integrated AIDS prevention and control information system,late diagnosis were analyzed according to the definition standard of late diagnosis currently used in China.Logistic regression was employed to investigate the association of late diagnosis and related influencing factors.Results From 2014 to 2023,a total of 1218 cases of HIV-infected and AIDS patients were found late in Hefei,the proportion of late diagnosis was 34.18%(1218/3564).Among them,58.13%(708/1218)were found by medical institutions,and 36.21%(441/1218)were found by testing and consulting.The majority of late found patients were Han,with male accounted for 90.97%.The mean age was(42.15±14.22)years.The inter-group distribution of age group,marital status,population nature,education level,occupation,transmission route,sample source,district/county,and time from diagnosis to CD4 detection were statistically significant(all P<0.05).Logistic multi-factor analysis showed that,compared with<25 age group,the older the age group,the higher the risk of late diagnosis.Compared with those with primary school education and below,those with college education and above had a lower risk of late diagnosis(OR=0.70,95%CI:0.51-0.95,P=0.020).Compared to the sources tested by medical institutions,testing and counseling(OR=0.45,95%CI:0.38-0.53),positive spouse/sexual partner testing(OR=0.31,95%CI:0.14-0.67),detention personnel testing(OR=0.50,95%CI:0.29-0.86),unpaid blood donors testing(OR=0.35,95%CI:0.20-0.62),other tests(OR=0.50,95%CI:0.28-0.90)had a lower risk of late diagnosis of HIV/AIDS(all P<0.05).The risk of late diagnosis was lower when the time interval between case diagnosis and CD4 detection was≥15 days compared with<15 d.People with unknown ST

关 键 词：艾滋病 晚发现 医疗机构 

分 类 号：R512.91[医药卫生—内科学] R181.3[医药卫生—临床医学]