山东大学学报 (医学版) ›› 2023, Vol. 61 ›› Issue (1): 100-105.doi: 10.6040/j.issn.1671-7554.0.2022.1031
• 公共卫生与管理学 • 上一篇
王炯炯1,2,王国永3,4,朱晓艳3,4,李玲3,4,张娜3,4,刘云霞1,2,4
WANG Jiongjiong1,2, WANG Guoyong3,4, ZHU Xiaoyan3,4, LI Ling3,4, ZHANG Na3,4, LIU Yunxia1,2,4
摘要: 目的 探讨山东省经同性传播人类免疫缺陷病毒(HIV)感染者抗病毒治疗(ART)及时性的影响因素,为进一步控制HIV的传播流行提供参考依据。 方法 选取2018年山东省1 926例新诊断经同性传播HIV感染者为研究对象,采用回顾性队列研究收集相关资料,采用二分类Logistic回归分析ART及时性的影响因素。 结果 2018年山东省经同性传播HIV感染者1 926例,诊断基线年龄中位数为31.15岁,诊断基线CD4细胞水平中位数为364个/μL,ART及时率为73.94%。户籍为省外的HIV感染者及时接受ART的可能性低于山东省内感染者(OR=0.59, 95%CI: 0.40~0.87),由羁押人群发现的HIV感染者及时接受ART的可能性低于重点人群(OR=0.25, 95%CI: 0.11~0.59),诊断基线CD4细胞水平为351~499和≥500个/μL的HIV感染者及时接受ART的可能性低于≤350个/μL者(OR=0.71, 95%CI: 0.53~0.96; OR=0.50, 95%CI: 0.38~0.66)。 结论 需进一步提高山东省经同性传播HIV感染者ART及时率,要特别注意省外户籍、羁押人群及诊断基线CD4细胞水平较高者,使其尽快接受ART,以进一步控制HIV的传播流行。
中图分类号:
[1] 陆莲凤, 吕玮, 李太生. 艾滋病诊治的过去、现在和未来[J]. 中华医学信息导报, 2021, 36(23): 9. doi: 10.3760/cma.j.issn.1000-8039.2021.23.108. LU Lianfeng, LYU Wei, LI Taisheng. The past, present and future of AIDS treatment [J]. China Medical News, 2021, 36(23): 9. doi: 10.3760/cma.j.issn.1000-8039.2021.23.108. [2] 刘童童, 李杰, 马烨, 等. 中国性病艾滋病防治协会艾滋病学术交流平台建设十年回顾[J]. 中国艾滋病性病, 2022, 28(7): 766-768. LIU Tongtong, LI Jie, MA Ye, et al. A 10-year review of the construction of the AIDS academic exchange platform of the Chinese association for STD and AIDS prevention and control [J]. Chinese Journal of AIDS & STD, 2022, 28(7): 766-768. [3] Wong NS, Mao J, Cheng WB, et al. HIV linkage to care and retention in care rate among MSM in Guangzhou, China [J]. AIDS and Behavior, 2018, 22(3): 701-710. [4] Unaids: Global HIV & AIDS statistics-fact sheet [OL]. [2021]. https://www.unaids.org/en/resources/fact-sheet. [5] 何纳. 中国艾滋病流行新变化及新特征[J]. 上海预防医学, 2019, 31(12): 963-967. HE Na. Emerging changes and characteristics of the HIV epidemic in China [J]. Shanghai Journal of Preventive Medicine, 2019, 31(12): 963-967. [6] 中华医学会感染病学分会艾滋病丙型肝炎学组, 中国疾病预防控制中心. 中国艾滋病诊疗指南(2021年版)[J]. 协和医学杂志, 2022, 13(13): 203-226. Chinese Medical Association, Chinese Center for Disease Control and Prevention. Chinese guidelines for diagnosis and treatment of human immunodeficiency virus infection/acquired immunodeficiency syndrome(2021 edition)[J]. Medical Journal of Peking Union Medical College Hospital, 2022, 13(13): 203-226. [7] 甘秀敏, 赵德才, 赵燕, 等. 2003—2021年我国艾滋病抗病毒治疗工作进展情况分析[J]. 中国艾滋病性病, 2022, 28(6): 642-646. GAN Xiumin, ZHAO Decai, ZHAO Yan, et al. Progress on national antiretroviral treatment program during 2003-2021 in China [J]. Chinese Journal of AIDS & STD, 2022, 28(6): 642-646. [8] Zucker J, Carnevale C, Gordon P, et al. Am i positive? Improving human immunodeficiency virus testing in the era of preexposure prophylaxis and immediate antiretroviral therapy using machine learning [J]. Open Forum Infect Dis, 2022, 9(7): ofac259. doi: 10.1093/ofid/ofac259. [9] 卜岚, 白轩, 朱自荣. 早期抗病毒治疗对艾滋病患者CD4+T淋巴细胞计数及耐药发生情况的影响[J].临床医学研究与实践, 2020, 5(22): 40-42. BU Lan, BAI Xuan, ZHU Zirong. Effects of early antiviral therapy on CD4+ T lymphocyte count and drug resistance in AIDS patients [J]. Clinical Research and Practice, 2020, 5(22): 40-42. [10] 吴泓靓, 陈碧正. 基于Logistic回归分析艾滋病高效抗逆转录病毒治疗患者病毒载量抑制失败的高危因素[J]. 中国性科学, 2021, 30(12): 150-152. WU Hongliang, CHEN Bizheng. High-risk factors for viral load inhibition failure in AIDS patients with HAART: a Logistic regression analysis [J]. Chinese Journal of Human Sexuality, 2021, 30(12): 150-152. [11] 陈欢欢, 刘鹏涛, 阮玉华. 我国免费艾滋病抗病毒治疗策略与“治疗即预防”进展情况[J]. 中国热带医学, 2019, 19(12): 1194-1196. CHEN Huanhuan, LIU Pengtao, RUAN Yuhua. Progress of chinas national free AIDS antiretroviral treatment program and "Treatment as Prevention" [J]. China Tropical Medicine, 2019, 19(12): 1194-1196. [12] 任徽. 大连市高新区HIV/AIDS未接受抗病毒治疗的原因及影响因素分析[J]. 中国民康医学, 2018, 30(16): 80-82. REN Hui. Analysis of causes and influencing factors of HIV/AIDS patients not receiving antiretroviral therapy in High-tech zone of Dalian City [J]. Medical Journal of Chinese Peoples Health, 2018, 30(16): 80-82. [13] 杨文婷, 马文, 谭兴兰. 2017—2020年重庆市北碚区新报告HIV感染者/AIDS病例抗病毒治疗及时性影响因素分析[J]. 寄生虫病与感染性疾病, 2022, 20(2): 69-73. YANG Wenting, MA Wen, TAN Xinglan. Influencing factors on the timeliness of antiviral therapy initiation in newly reported HIV/AIDS patients in Beibei District of Chongqing from 2017 to 2020 [J]. Parasitoses and Infectious Diseases, 2022, 20(2): 69-73. [14] 杨杰, 赵淑娟, 黄丽丽, 等. 2017—2020年河南省许昌市新报告HIV/AIDS病例早期接受抗病毒治疗的影响因素[J]. 河南预防医学杂志, 2022, 33(3): 193-196. YANG Jie, ZHAO Shujuan, HUANG Lili, et al. Analysis of early antiretroviral therapy among newly reported HIV/AIDS cases in Xuchang city, Henan province from 2017 to 2020 [J]. Henan Journal of Preventive Medicine, 2022, 33(3): 193-196. [15] 李想, 王毓倩, 唐义红. 浅述我国艾滋病社会保障制度构建[J]. 医学与法学, 2019, 11(2): 79-85. LI Xiang, WANG Yuqian, TANG Yihong. Discussions on social security system for AIDS patients in China [J]. Medicine and Jurisprudence, 2019, 11(2): 79-85. [16] 夏春雨, 黎桂福, 李艳芬, 等. 某监狱内HIV/AIDS患者抗病毒治疗意愿及影响因素分析[J]. 公共卫生与预防医学, 2022, 33(4): 113-117. XIA Chunyu, LI Guifu, LI Yanfen, et al. Willingness and influencing factors of antiviral treatment of HIV/AIDS patients in a prison [J]. Journal of Public Health and Preventive Medicine, 2022, 33(4): 113-117. [17] 郭燕, 赵芳凝, 候金宇, 等. 天津市2016~2020年新报告HIV/AIDS患者抗病毒治疗及时性分析[J]. 中国艾滋病性病, 2022, 28(1): 78-81. GUO Yan, ZHAO Fangning, HOU Jinyu, et al. Analyse the timeliness of initiation anti-retroviral treatment among newly diagnosed HIV/AIDS cases in Tianjin, 2016-2020 [J]. Chinese Journal of AIDS & STD, 2022, 28(1): 78-81. [18] 宋明明, 张娜娜, 郑元元, 等. 2015~2019年潍坊市羁押人员HIV感染率及危险因素分析[J]. 预防医学论坛, 2021, 27(5): 330-331. SONG Mingming, ZHANG Nana, ZHENG Yuanyuan, et al. Analysis on prevalence and risk factors of HIV among detainees, Weifang city, 2005-2019 [J]. Preventive Medicine Tribune, 2021, 27(5): 330-331. [19] Martins MV, Vassard D, Hougaard CØ, et al. The impact of ART on union dissolution: a register-based study in Denmark 1994-2010 [J]. Hum Reprod, 2018, 33(3): 434-440. [20] 赵亚芳, 绳宇. 男男性行为者中新确诊HIV感染者及时衔接医疗行为情况及因素分析[J]. 中国艾滋病性病, 2022, 28(5): 540-544. ZHAO Yafang, SHENG Yu. Timely linkage to care among men who have sex with men with newly diagnosed as HIV and related factors [J]. Chinese Journal of AIDS & STD, 2022, 28(5): 540-544. [21] 胡冰, 胡允凯, 贺磊, 等. 阜阳市HIV单阳家庭及时开展抗病毒治疗情况及其相关因素分析[J]. 现代预防医学, 2018, 45(10): 1868-1870. HU Bing, HU Yunkai, HE Lei, et al. Analysis of the situation and the associating factors for the timeliness of antiretroviral therapy among HIV sero-discordant couples in Fuyang [J]. Modern Preventive Medicine, 2018, 45(10): 1868-1870. [22] 黄小青, 谢天, 钟炳志, 等. 成都市郫都区HIV/AIDS患者抗病毒治疗及时性及影响因素分析[J]. 预防医学情报杂志, 2022, 38(4): 506-510. HUANG Xiaoqing, XIE Tian, ZHONG Bingzhi, et al. Analysis of the timeliness of antiviral treatment in HIV/AIDS patients in Chengdus Pidu District and its influencing factors [J]. Journal of Preventive Medicine Information, 2022, 38(4): 506-510. [23] 庄梅珠, 许爱玲, 瞿洪波. 2020年无锡市梁溪区艾滋病抗病毒治疗患者CD4+T淋巴细胞计数和病毒载量检测结果分析[J]. 应用预防医学, 2022, 28(2): 182-184. ZHUANG Meizhu, XU Ailing, QU Hongbo. Analysis of CD4+T lymphocyte count and viral load in HIV/AIDS patients on antiretroviral therapy in Liangxi District, Wuxi City, 2020 [J]. Journal of Applied Preventive Medicine, 2022, 28(2): 182-184. [24] Liu PT, Tang ZZ, Lan GH, et al. Early antiretroviral therapy on reducing HIV transmission in China: strengths, weaknesses and next focus of the program [J]. Sci Rep, 2018, 8(1): 3431. doi: 10.1038/s41598-018-21791-2. [25] Fiorentino M, Nishimwe M, Protopopescu C, et al. Early ART initiation improves HIV status disclosure and social support in people living with HIV, linked to care within a universal test and treat program in rural south africa(ANRS 12249 TasP Trial)[J]. AIDS Behav, 2021, 25(4): 1306-1322. [26] Gill MJ, Powell M, Vu Q, et al. Economic impact on direct healthcare costs of missing opportunities for diagnosing HIV within healthcare settings [J]. HIV Med, 2021, 22(8): 723-731. [27] 尹宁, 王震宇, 倪莹青, 等. 上海市长宁区 HIV/AIDS 病人抗病毒治疗开始时间及其影响因素[J]. 中国艾滋病性病, 2020, 26(11): 1174-1177. YIN Ning, WANG Zhenyu, NI Yingqing, et al. Time of antiretroviral therapy initiation of HIV/AIDS patients in Changning district, Shanghai and its effect factors [J]. Chinese Journal of AIDS & STD, 2020, 26(11): 1174-1177. |
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