2012—2016年新报告HIV感染者首次CD4^+T淋巴细胞检测情况分析

First CD4^+ T cell test of newly reported HIV/AIDS cases between 2012 and 2016

目的分析2012—2016年新报告艾滋病病毒（HIV）感染者首次CD4~＋T淋巴细胞（CD4细胞）检测情况,为提高CD4细胞检测及时性,推动及早抗病毒治疗提供参考信息。方法使用截至2017年12月31日的艾滋病网络直报HIV感染者报告卡和随访管理定时数据库,运用频数分布和二分类Logistic回归模型等方法,对2012—2016年新报告HIV感染者的首次CD4细胞检测情况进行分析比较。结果 2012—2016年新报告HIV感染者444 698例。在14天内进行CD4细胞检测的比例从2012年的49.2%（31 229/63 490）升高到2016年的60.0%（692 251/115 346）（趋势χ~2=2 483.079,P〈0.001）。多因素Logistic回归分析显示,高年龄组、男性、未婚、离异或丧偶、家政、家务及待业、离退人员、注射吸毒、来源于医疗机构、羁押场所检测和献血员体检的HIV感染者及时检测比例较低。2012—2016年,诊断一年内进行了CD4细胞检测的新报告HIV感染者中,检测结果低于200个/μL的比例逐年下降（趋势χ~2=254.088,P〈0.001）。高年龄组和来源于医疗机构检测的HIV感染者首次CD4细胞低于350个/μL的比例更高。结论新报告HIV感染者CD4细胞检测及时性逐年提高,CD4细胞低于200个/μL的比例逐年降低。随访管理工作中,针对年龄较大、注射吸毒传播和来源于医疗机构检测的HIV感染者,应加强咨询、促进及早CD4细胞检测,有助于帮助其及早启动抗病毒治疗。

Objective To analyze the CD4＋T cell testing（CD4 test）among newly reported HIV/AIDS cases between 2012 and 2016,to provide reference for starting ART in time.Methods Data were collected from HIV/AIDS case reporting cards and follow-up cards as of December 31st,2017.The first CD4 test of newly reported cases between 2012 and 2016 were analyzed by frequency distribution and binary logistic regression model.Results The proportions of CD4 test within 14 days in newly reported cases increased from 49.2%in 2012 to 60.0%in 2016（χ2=2 483.079,P〈0.001）.Binary logistic regression analysis showed that lower proportion of CD4 test timeliness among those who were in high age group,male,never married,divorced/widowed,people whose occupation was listed as homemaker or unemployed,retired,being transmitted through injecting drug use and diagnosed at hospitals/clinics,detention center or blood donation station.The rate of less than 200 CD4＋T cells perμL decreased from2012 to 2016（χ2=254.088,P〈0.001）.People who were in high age group and diagnosed at hospital/clinics had higher risks of less than 350 CD4＋T cell perμL.Conclusion The proportion of CD4 test timeliness of newly reported cases increased in recent years.Highly effective counseling and recommendation of CD4 test and ART should focus on those who are in high age group,being transmitted through injecting drug use and diagnosed at hospital/clinics.