布拖县艾滋病病毒感染儿童抗病毒治疗及时性及治疗效果评价

Evaluation of the Timeliness and the Effect of Anti-retroviral Treatment on Children Infected With HIV in Butuo County

目的了解布拖县艾滋病病毒感染儿童抗病毒治疗及时性及治疗效果。方法采用描述性研究,收集首例HIV感染儿童纳入治疗至2019年底布拖县艾滋病病毒感染儿童的抗病毒治疗信息,利用卡方检验等统计学方法进行治疗基本情况、治疗及时性、CD4计数和病毒载量检测结果等的分析。检验水准为α=0.05。结果截至2019年底,布拖县累计治疗儿童共877例,治疗时长中位数为18.0(14.7,46.3)月。儿童开始治疗和确诊时间间隔<1个月的比例从2010年的14.3%上升至2019年的41.9%(χ^(2)趋势=207.178,P<0.001)。随着治疗时间的延长,各年龄组儿童CD4细胞计数整体呈现上升的趋势,其中女童的增长幅度大于男童,各年龄段儿童在治疗24个月后CD4计数均保持在600个/μl以上。儿童的病毒载量水平在治疗611个月、1223个月、2435个月、≥36个月后低于200 cps/ml的比例分别是73.7%、68.9%、62.8%和88.3%,统计学检验有差异(χ^(2)=38.708,P<0.001),且两两比较结果表明治疗满36个月后的病毒载量结果与其他治疗阶段均有差异;不同性别间病毒载量低于200 cps/ml的比例比较,治疗满6个月时女童高于男童,但是治疗12个月、24个月和36个月后两者接近。结论布拖县抗病毒治疗儿童数量大,确诊后1个月内开始治疗的比例呈现上升趋势,儿童CD4计数随着治疗时间延长逐步升高,坚持治疗的儿童病毒载量维持在较低水平。

Objective To explore the timeliness and the effect of antiviral treatment in children infected with HIV in Butuo county.Methods Descriptive research method was used to analysis the information on anti-retroviral treatment of the first HIV-infected children in Butuo county until the end of 2019.And statistical methods such as t-test,chi-square test were used to analyze the basic treatment informtion,CD4count,viral load,treatment effects,etc.The test level wasα=0.05.Results There were 877 children who had received AIDS antiviral treatment by the end of 2019.The median duration of treatment was 18.0 (14.7,46.3) months.The proportion of children whose time interval between treatment and diagnosis being less than 1 month had increased from 14.3%in2010 to 41.9%in 2019(χ^(2)trend=207.178,P<0.001).With the extension of treatment time,the CD4cell counts of children of all age groups showed an overall upward trend.The growth rate of the CD4counts of girls was greater than that of boys,and the CD4counts of children of all ages remained above 600cellls/ul after 24 months of treatment.After 6-11 months,12-23 months,24-35months,and≥36 months of treatment,the proportion of viral loads less than 200cps/ml was 73.7%、68.9%、62.8%、88.3%,respectively,and the test result was statistically different(χ^(2)=38.708,P<0.001).Besides,the pairwise comparison results showed that the viral load results after 36 months of treatment were different from other treatment stages.The comparison of the proportion of the viral load of less than 200 cps/ml between different sexes found that girls were higher than boys at6 months of treatment,but they were similar after 12 months,24 months and 36 months of treatment.Conclusion There are a large number of children receiving antiretroviral treatment in Butuo county,and the proportion of children starting treatment within one month after diagnosis is on the rise.CD4counts of children gradually increased with the extension of treatment time,and the viral load of children who insist on treatment is maintained at a low level.