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云南省艾滋病抗病毒治疗中HIV低病毒血症发生情况分析

安靓 劳云飞 唐松源

安靓, 劳云飞, 唐松源. 云南省艾滋病抗病毒治疗中HIV低病毒血症发生情况分析[J]. 中国公共卫生, 2022, 38(7): 908-913. doi: 10.11847/zgggws1132975
引用本文: 安靓, 劳云飞, 唐松源. 云南省艾滋病抗病毒治疗中HIV低病毒血症发生情况分析[J]. 中国公共卫生, 2022, 38(7): 908-913. doi: 10.11847/zgggws1132975
AN Jing, LAO Yun-fei, TANG Song-yuan. Incidence of low-level viraemia among HIV/AIDS patients with antiviral therapy in Yunnan province, 2004 – 2018: a retrospective analysis[J]. Chinese Journal of Public Health, 2022, 38(7): 908-913. doi: 10.11847/zgggws1132975
Citation: AN Jing, LAO Yun-fei, TANG Song-yuan. Incidence of low-level viraemia among HIV/AIDS patients with antiviral therapy in Yunnan province, 2004 – 2018: a retrospective analysis[J]. Chinese Journal of Public Health, 2022, 38(7): 908-913. doi: 10.11847/zgggws1132975

云南省艾滋病抗病毒治疗中HIV低病毒血症发生情况分析

doi: 10.11847/zgggws1132975
基金项目: 云南省科学技术厅项目(202001AY070001 – 105)
详细信息
    作者简介:

    安靓(1987 – ),女,四川省安岳县人,研究实习员,硕士在读,主要从事艾滋病抗病毒治疗质量控制工作

  • 中图分类号: R 512.91

Incidence of low-level viraemia among HIV/AIDS patients with antiviral therapy in Yunnan province, 2004 – 2018: a retrospective analysis

  • 摘要:   目的  了解云南省抗病毒治疗中HIV低病毒血症发生的总体情况和变化趋势,为后续相关研究提供参考。  方法  从艾滋病综合防治数据信息管理系统下载既有数据,对2004 — 2018年在云南省接受艾滋病抗病毒治疗(ART)的患者人口学特征和病毒载量(VL)检测结果进行描述性分析,按照治疗方案分为2个子队列进行统计分析。  结果  93944例患者中有21203例发生低病毒血症(LLV),总发生率为22.6 %,其中25.5 %发生了至少2次。按数值水平看,51~199拷贝/mL的发生率最高,然后是400~999、200~399拷贝/mL;按发生频率看,发生单独1次LLV的比例最高,连续2次、间隔2次、连续多次、间隔多次发生LLV的比例依次下降。按随访年分析,开始ART第1年低病毒血症的发生率最高,此后逐年下降。按自然年分析,一线治疗队列中 LLV 51~199拷贝/mL与LLV 200~399拷贝/mL发生率有相同趋势,先上升至2010年的峰值,之后开始下降至2016年谷值,之后又上升;LLV 400~999拷贝/mL与病毒学失败(VF)≥ 1000拷贝/mL发生率相似,2012年前逐年下降,之后平稳维持。二线治疗队列中4种VL检测结果有相同趋势,均在2008 — 2012年有下降趋势,之后平稳维持。  结论  云南省ART人群中LLV发生率较高,应进一步探索LLV对ART治疗效果的影响。
  • 图  1  患者随访年LLV和VF的发生率

    图  2  患者自然年LLV和VF的发生率

    表  1  病例基本人口学特征

    特征一线治疗队列(N = 76736)二线治疗队列(N = 17208)χ2/HP
    n%n%
    性别 2257 < 0.001
     男性 48785 63.6 7561 43.9
     女性 27951 36.4 9647 56.1
    婚姻状况 199.58 < 0.001
     未婚 14583 19.0 2850 16.6
     已婚或同居 50605 65.9 12273 71.3
     离异或分居 7131 9.3 1310 7.6
     丧偶 4072 5.3 741 4.3
     不详 345 0.4 34 0.2
    传播途径 1856.9 < 0.001
     静脉吸毒 13227 17.2 2946 17.1
     同性性传播 3019 3.9 357 2.1
     异性性传播 55890 72.8 13023 75.7
     其他(以不详为主) 4599 6.0 882 5.1
    随访时长(年) 686.86 < 0.001
     < 1 8474 11.0 2599 15.1
     1~3 24407 31.8 6053 35.2
     3~5 18395 24.0 4501 26.2
     > 5 25460 33.2 4055 23.6
    开始治疗年代 3197.7 < 0.001
     < 2012 22136 28.8 1421 8.3
     2012 — 2015 35839 46.7 10040 58.3
     ≥ 2016 18761 24.4 5747 33.4
    开始治疗州市 508.68 < 0.001
     西双版纳州 1606 2.1 307 1.8
     保山市 3521 4.6 920 5.3
     楚雄州 2495 3.3 359 2.1
     大理州 5479 7.1 1318 7.7
     德宏州 7595 9.9 2381 13.8
     迪庆州 157 0.2 20 0.1
     红河州 14511 18.9 3333 19.4
     昆明市 13969 18.2 2873 16.7
     丽江市 668 0.9 121 0.7
     临沧市 5903 7.7 1478 8.6
     怒江州 452 0.6 108 0.6
     普洱市 3364 4.4 728 4.2
     曲靖市 3993 5.2 762 4.4
     文山州 6599 8.6 1489 8.7
     玉溪市 2665 3.5 510 3.0
     昭通市 3073 4.0 364 2.1
     其他省市 686 0.9 137 0.8
    下载: 导出CSV

    表  2  低病毒血症总体发生情况

    特征一线治疗队列(N = 76736)二线治疗队列(N = 17208)
    n%n%
    发生低病毒血症 17 832 23.2 3371 19.6
     病毒载量(拷贝/mL)
      50~199 10 542 59.1 2034 60.3
      200~399 3 413 19.1 666 19.8
      400~999 3 877 19.9 671 19.9
     发生频率
      单独1次 13 119 73.6 2683 79.6
      连续2次 1 891 10.6 347 10.3
      间隔2次 1 670 9.4 217 6.4
      连续多次 557 3.1 71 2.1
      间隔多次 595 3.3 53 1.6
    下载: 导出CSV
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  • 收稿日期:  2020-11-02
  • 网络出版日期:  2021-12-13
  • 刊出日期:  2022-07-10

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