安徽省AIDS病人ART效果追踪

Follow-up of efficacy of ART for people living with AIDS in Anhui,China

目的在既往献血员集中地区开展疗效评估,以了解接受抗反转录病毒治疗(ART)的艾滋病(AIDS)病人的治疗效果。方法 2007年建立队列,采取多阶段单纯随机抽样方法在既往献血的艾滋病人集中地区,抽取接受抗病毒治疗的病人参加研究。2010年对该队列进行追踪问卷调查和实验室检测,其中问卷调查包括基本情况和生活治疗36条目简明量表(SF-36)中文版问卷。结果 2007年共纳入队列124人,2010年共追踪113人,死亡9人,失访2人(外出打工)。队列中,3年累计病死率为7.25%。3年来队列人群的职业构成中,从事非全职务农的比例提高,其他人口学指标变化不大。绝大多数病人能按期接受医学随访,按时按量服用抗病毒药物,且两个指标均呈现上升趋势,但差异无统计学意义。CD4计数明显升高,低于200的比例下降(18.7%比10.0%)(χ2=3.526,P=0.060),病毒载量检出率下降明显(20.2%比14.6%)(χ2=3.969,P=0.046)。研究队列的生理职能(RP)、肌体疼痛(BP)、总体健康(GH)和活力(VT)4个领域得分下降,其他4个领域没有变化。结论此研究采用队列研究方法,发现接受抗病毒治疗的艾滋病病人依从性高,抗病毒治疗效果显著,但用SF-36评价的生活质量得分没有提高。需要进一步研究如何评价和提高既往献血感染艾滋病人群的生活质量。

Objective To identify the efficacy of antiretroviral therapy（ART） for people living with AIDS（PLWA） in areas with a large number of former plasma donors.Methods In 2007 a cohort of PLWA was set up to investigate the efficacy of ART in areas with a large number of former plasma donors in Anhui,using simple random sampling method.In 2010,the cohort was followed-up.The recruited PLWA participated in a face-to-face interview with a structured questionnaire to collect basic demographic information and assess quality of life using SF-36 form.Blood samples were collected to test CD4 counts and viral load（VL） level.Results There were 124 PLWA recruited in the cohort in 2007.In 2010,113 in the cohort were followed-up,9 died and 2 lost（moving to work in other areas）.The cumulative mortality of the cohort in 3 years was 7.25%.After 3 years,the proportion of working in other fields than farming increased,and all other demographic characteristics did not changed much.Most of the cohort received medical follow-ups,and took ARV medicines regularly.Both indicators were increasing,but not statistically significant.CD4 counts were increasing in the cohort with the proportion of having less than 200 decreased from 18.7% in 2007 to 10.0% in 2010（χ2=3.526,P=0.060）.The proportion of having tested viral load decreased from 20.2% to 14.6%（χ2=3.969,P=0.046）.The quality of life scores in 4 fields（RP,BP,GH,and VT） decreased and the scores in the other 4 fields did not change.Conclusions The cohort study showed that the PLWA cohort was highly adhered to ART,which was effective,but the quality of life scores using SF-36 form were not improving.Further studies will be needed to assess and improve the quality of life of PLWA receiving ART in areas with a large number of former plasma donors.