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陈亮, 连巧龄, 张明雅, 郑武雄. 福建省未接受抗病毒治疗HIV/AIDS病例特征分析[J]. 中国公共卫生, 2018, 34(6): 903-907. DOI: 10.11847/zgggws1115251
引用本文: 陈亮, 连巧龄, 张明雅, 郑武雄. 福建省未接受抗病毒治疗HIV/AIDS病例特征分析[J]. 中国公共卫生, 2018, 34(6): 903-907. DOI: 10.11847/zgggws1115251
Liang CHEN, Qiao-ling LIAN, Ming-ya ZHANG, . Characterization of antiretroviral therapy-naïve HIV/AIDS patients in Fujian province[J]. Chinese Journal of Public Health, 2018, 34(6): 903-907. DOI: 10.11847/zgggws1115251
Citation: Liang CHEN, Qiao-ling LIAN, Ming-ya ZHANG, . Characterization of antiretroviral therapy-naïve HIV/AIDS patients in Fujian province[J]. Chinese Journal of Public Health, 2018, 34(6): 903-907. DOI: 10.11847/zgggws1115251

福建省未接受抗病毒治疗HIV/AIDS病例特征分析

Characterization of antiretroviral therapy-naïve HIV/AIDS patients in Fujian province

  • 摘要:
      目的  探讨福建省未接受抗病毒治疗艾滋病病毒感染者/艾滋病患者(HIV/AIDS)病例的分布特征及其影响因素。
      方法  采用统一设计的调查问卷对所有符合条件的HIV/AIDS病例进行调查,收集基本人口学、疾病状态、CD4细胞检测和抗病毒治疗情况,应用单因素和多因素分析法探讨抗病毒治疗的影响因素。
      结果  1987年1月1日 — 2016年12月31日,未接受抗病毒治疗HIV/AIDS病例4 054例,占累计报告病例的37.6 %。报告死亡1 274例,占31.4 %,病例报告当月发生死亡350例,占27.5 %。CD4细胞计数为(439.97 ± 245.93)个/μL,明显高于接受抗病毒治疗组(283.73 ± 196.06)个/μL(t = 29.985,P < 0.01)。女性(OR = 1.244, 95 % CI = 1.079~1.434)、35~44岁(OR = 1.249, 95 % CI = 1 .059~1.474)和45~54岁(OR = 1.420, 95% CI = 1.177~1.712)、高中或中专(OR = 1.369, 95 % CI = 1.062~1.764)和大专及以上(OR = 1.526, 95 % CI = 1.175~1.983)、AIDS(OR = 4.370, 95 % CI = 3.597~5.309)、CD4细胞计数200~349个/μL(OR = 2.800, 95 % CI = 2.238~3.503)和350~49个/μL (OR = 1.400, 95 % CI = 1.115~1.758)等是接受抗病毒治疗的有利因素,2016年及之后报告(OR = 0.207, 95 % CI = 0.165~0.259)、确认阳性后3~6个月 (OR = 0.689, 95 % CI = 0.568~0.836)和 ≥ 6个月 (OR = 0.446, 95 % CI = 0.367~0.541)进行CD4细胞检测、CD4细胞计数 ≥ 500个/μL(OR = 0.445, 95 % CI = 0.355~0.556)等是接受抗病毒治疗的不利因素。
      结论  福建省HIV/AIDS病例未接受抗病毒治疗的比例较高。应针对抗病毒治疗实施的影响因素采取针对性的应对策略,提高抗病毒治疗的覆盖率,降低艾滋病的死亡率。

     

    Abstract:
      Obejective  To explore the characteristics and its relevant factors of antiretroviral therapy-naïve patients with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in Fujian province.
      Methods  We recruited all HIV/AIDS patients registered from January 1st, 1987 through 2016 in Fujian province and conducted a questionnaire survey to collect information on basic demographics, disease status, CD4 cell test, and antiretroviral therapy among the participants. Univariate and multivariate analysis were used to identify influencing factors of antiretroviral therapy.
      Results  There were 4 054 registered antiretroviral therapy-naïve HIV/AIDS cases, accounting for 37.6% of the all HIV/AIDS cases registered during the period. Totally 1 274 deaths (31.4%) were reported among the all registered therapy-naïve HIV/AIDS cases and 27.5% of the death cases were reported within the first month of case registry. The average CD4 cell count was 439.97 ± 245.93 cells/μL among the therapy-naïve HIV/AIDS cases, significantly higher than that (283.73 ± 196.06 cells/μL) among the cases with antiretroviral therapy (t = 29.985, P < 0.01). Multivariate conditional logistic regression analysis indicated that promoting factors for the registered HIV/AIDS cases to receive antiretroviral therapy included female gender (odds ratio OR = 1.244, 95% confidence interval 95% CI: 1.079 – 1.434), aged 35 – 44 years (OR = 1.249, 95% CI: 1.059 – 1.474), aged 45 – 54 years (OR = 1.420, 95% CI: 1.177 – 1.712), with the education of senior high school or technical secondary school (OR = 1.369, 95% CI: 1.062 – 1.764), with the education of junior college and above (OR = 1.526, 95% CI: 1.175 – 1.983), diagnosed with AIDS (OR = 4.370, 95% CI: 3.597 – 5.309), with a CD4 cell count of 200 – 349 cells/μL (OR = 2.800, 95% CI: 2.238 – 3.503), with a CD4 cell count of 350 – 499 cells/μL (OR = 1.400, 95% CI: 1.115 – 1.758); while the hindering factors were being registered in and after 2016 (OR = 0.207, 95% CI: 0.165 – 0.259), having a CD4 cell count detection within 3 – 6 months after the confirmation of HIV positive (OR = 0.689, 95% CI: 0.568 – 0.836) and within 6 months and after (OR = 0.446, 95% CI: 0.367 – 0.541), and with a CD4 cell count of ≥ 500 cells/μL (OR = 0.445, 95% CI: 0.355 – 0.556).
      Conclusion  The proportion of antiretroviral therapy-naïve patients was high among the registered HIV/AIDS patients in Fujian province, suggesting strategies specific to factors related to implementation of antiretroviral therapy should be developed to promote antiretroviral therapy in the patients.

     

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