河南省某县HIV感染者耐药性影响因素分析

Study on influencing factors of emergence of HIV drug resistance in one county of Henan province

目的了解河南省某县抗人类免疫缺陷病毒(HIV)治疗病人耐药毒株产生的影响因素。方法对河南省某县抗HIV治疗病人进行队列研究,采用问卷调查和实验室检测耐药性结合的方法,用寿命表方法计算累积耐药率,用COX回归方法分析耐药性产生的影响因素。结果河南省某县艾滋病患者抗病毒治疗时间为182.5,365,547.5,730d,累积耐药率分别为19.0%,35.8%,41.7%,48.2%。家庭人均月收入高、医生经常主动询问服药后情况和已婚是影响耐药产生的保护性因素,而治疗前有临床症状和3 d内漏服治疗药物是耐药产生的危险因素。结论应加大医疗救助、抗病毒治疗督导与管理、加强病人关怀等方面的力度,努力提高病人服药的依从性,以减缓耐药毒株的产生。

Objective To understand the influencing factors of the emergence of HIV drug resistance in antiretroviraltreated patients infected with HIV/AIDS in Henan, China. Methods Cohort study was performed in the HIV infected patients receiving antiretroviral treatment. Investigation and blood collection for drug resistance detection were conducted to study the emergence and influencing factors of HIV drag resistance. The cumulative rate of drug resistance was calculated by life table and influencing factors by Cox regression. Results The cumulative rates of drug resistance in half a year, one year, one and a half years and two yearn were 19.0 %, 35.8 %, 41.7 %, 48.2 %. Higher average income of every person of the family, high frequency of the doctors asking the states of the patients after treatment and being married were the protecting factors. The risk factors were occured symptoms before therapy and poor adherence based on 3 - day recall. Conclusion Enhanced the salvation and care to the HIV infected patients and strengthening the supervision on the patients undergoing therapy was necessary to enhance the adherence to therapy and reduce the emergence speed of the resistant strains.