福建省HIV/AIDS儿童抗病毒治疗现况及效果分析

Current status and effect of antiviral therapy in children with HIV/AIDS in Fujian province

目的了解福建省接受抗病毒治疗艾滋病感染者/患者(HIV/AIDS)儿童的现况及营养/免疫学治疗效果,为今后进一步优化和完善患儿治疗管理模式提供依据。方法从"艾滋病综合防治数据信息管理系统"中下载福建省2005—2015年≤15岁HIV/AIDS儿童抗病毒治疗资料,对其治疗基本情况、体格生长和免疫学效果等进行分析。结果福建省累计治疗HIV/AIDS儿童47例,95.74%(45/47)经母婴传播途径感染。启动抗病毒治疗平均年龄中位数4.69岁(0.89~14.7岁),平均治疗时长为30.4(6~115.56)月。抗病毒治疗前,HIV/AIDS儿童的身高、体重、血红蛋白水平明显低于正常同龄儿童,分别有61.70%(29/47)、48.57%(17/35)出现不同程度的体格发育不良和贫血;接受治疗后最近1次的随访检测结果发现,体格发育不良和贫血比例分别降为42.55%(20/47)、14.28%(5/35),治疗前后差异具有统计学意义(P=0.035,P=0.019)。随着治疗时间的延长,CD4+T淋巴细胞(CD4细胞)计数逐渐增长,治疗3、6、12、24、36月后CD4计数分别增加了50.45%、55.86%、57.68%、75.36%、84.09%,与基线CD4细胞计数比较,差异均具有统计学意义(P<0.01)。结论本次调查分析表明,抗病毒治疗改善了福建省HIV/AIDS儿童营养水平,促进体格生长和机体免疫恢复。

Objective To describe the status and effect of antiretroviral therapy（ART） among children with human immunodeficiency virus/acquired immunodificiency syndrome（HIV/AIDS） in Fujian province, and to provide evidences for improving the quality and management of medication for the children. Methods The data on ART treated HIV/AIDS cases aged ≤ 15 years and reported from 2005 through 2015 in Fujian province were extracted from China Information System for HIV/AIDS Prevention and then the information on demographics, physical growth, nutrition status, and ART outcomes of the cases were collected and analyzed. Results Of the 47 children（30 boys and 17 girls） with HIV/AIDS, 95.74%（45/47） were infected through vertical transmission. The age at the time of receiving ART ranged from 0.89 to 14.97 years, with a median of 4.69 years. The average ART treatment duration for all the cases was 30.4 months. At the beginning of ART, the cases showed significantly lower height and weight than those of normal children, with the detection rate of 61.70%（29/47） and48.57%（17/35） for malnutrition and anemia; while, at the last follow-up examination after ART, the detection rate of malnutrition and anemia decreased to 42.55%（20/47） and 14.28%（5/35） and significantly lower than those before the ART（P = 0.035 and P = 0.019）. Among the cases, the count of CD4 positively lymphocytes（CD4＋T） increased gradually with the increment of ART duration; compared with the baseline values, the CD4＋T count increased by 50.45%, 55.86%, 57.68%,75.36%, and 84.09% at 3-, 6-, 12-, 24-, and 36-month after the ART, with significant differences（all P〈0.01）. ConclusionAntiviral therapy is beneficial to improve the nutrition condition and to promote physical development and immune recovery among the children with HIV/AIDS.