阿克苏地区214例人类免疫缺陷病毒感染者和艾滋病患者抗病毒治疗效果及影响因素分析

Effects and associated factors of anti-retroviral therapy among 214 HIV/AIDS patients in Aksu prefecture in Xinjiang of China

目的了解新疆阿克苏地区阿克苏市、库车市和阿瓦提等3县(市)人类免疫缺陷病毒(human immunodeficiency virus, HIV)感染者/艾滋病(acquired immune deficiency syndrome, AIDS)患者抗病毒治疗效果及影响因素。方法 2020年10—11月,采用方便抽样方法,以阿克苏地区阿克苏市、库车市和阿瓦提等3县(市)正在接受国家免费抗病毒治疗的HIV感染者/AIDS患者作为研究对象。运用χ2检验和秩和检验对研究对象的基本特征及服药和治疗情况进行统计学分析。采用Cochran-Mantel Haenszel检验和logistic回归模型对抗病毒治疗的影响因素进行单因素和多因素分析。结果阿克苏地区阿克苏市、库车市和阿瓦提等3县(市)的214例HIV感染者/AIDS患者的平均年龄为(38.47±9.84)岁,其中男性占44.86%(96/214);HIV感染者/AIDS患者的抗病毒治疗有效率为82.24%(176/214),而阿瓦提县仅为72.86%(51/70)。多因素分析结果显示:阿瓦提县、年龄≥50岁、确证至接受治疗时间>12个月、服药依从性较差是阿克苏地区HIV感染者/AIDS患者抗病毒治疗效果的危险因素;其他职业、基线CD4+T淋巴细胞计数>350个/μl、未服用美沙酮是阿克苏地区HIV感染者/AIDS患者抗病毒治疗效果的保护因素;抗病毒治疗有效组的社会支持总分高于无效组[(28.12±5.39)分vs(26.48±5.11)分],差异有统计学意义(t=2.29,P=0.028)。结论加强对阿克苏地区高龄、农牧民、服用美沙酮HIV感染者/AIDS患者的干预和管理,提高县(市)医务人员业务水平,完善患者社会保障和就业保障制度,进而提升抗病毒治疗效果。

Objective To study the effects and associated factors of anti-retroviral therapy(ART) among HIV/AIDS patients in Aksu, Kuqa and Awati county, Aksu prefecture in Xinjiang of China. Methods During October to November of 2020,the method of convenience sampling was adopted to recruit the research subjects.Chi-square test and Kruskal-Wallis test were performed to compare social-demographics and effects of ART of the research subjects in three counties. CMH test, t test and logistic regression model were used to examine associations among factors and effects. Results The average age of 214 respondents was(38.47±9.84) years old and 44.86%(96/214) were males.The effective rate of ART in Aksu prefecture was 82.24%(176/214), but that was only 72.86%(51/70) in Awati country.Multivariate analysis showed that the risk factors of anti-retroviral therapy in Aksu prefecture included Awati county, older than 50 years old, diagnosed HIV to ART over 12 months, poor medication compliance, and the protective factors were other occupations,baseline CD4+T>350/μl,not using methadone.The social support score of the virus suppressed group(28.12±5.39)was higher than that of the virus unsuppressed group(26.48±5.11). Conclusions The intervention and management of elder people,farmers and herdsmen,and HIV/AIDS patients taking methadone should be strengthened in Aksu prefecture.