492例艾滋病抗病毒治疗病人停药原因及影响因素分析

Factors influencing drug withdrawal in 492 AIDS patients receiving antiretroviral therapy

目的:探索艾滋病抗病毒治疗病人停药原因及影响因素,减少停药情况发生。方法:采用回顾性整群抽样研究方法,选取南阳市2002—2019年间接受艾滋病抗病毒治疗出现过停药情况的艾滋病病毒感染者作为研究对象,分析停药发生时间、原因、影响复治因素等。结果:共纳入492例病例,266例(54.07%)在开始治疗一年内停药,不同治疗年限停药人数存在明显差异(χ^(2)=29.78,P<0.05);因个人因素停药278例(56.50%);不同婚姻状况、职业、感染途径、停药时治疗年限、药物漏服情况以及确诊后是否一年内抗病毒治疗者的停药原因分布存在明显差异(P值均<0.05);影响停药病人及时复治的原因中,非农职业停药6个月内复治可能性是农民的2.063倍(95%CI:1.048~4.063);停药原因中,因病人个人原因停药后6个月内复治可能性是药物治疗因素的0.414倍(95%CI:0.246~0.696)。结论:艾滋病抗病毒治疗中应避免出现不必要的停药,停药后及时复治成为治疗成败的关键因素,加强病人服药依从性教育,优化用药方案可以减少停药情况发生。

Objective:To explore factors influencing drug withdrawal in HIV/AIDS patients receiving antiretroviral therapy. Methods: The retrospective cluster sampling method was used to select the HIV/AIDS patients who had stopped taking antiviral treatment in Nanyang city from 2002 to 2019 as the research objects, and the time, reasons and influencing factors of drug withdrawal were analyzed. Results: A total of 492 AIDS patients were included in this study, and 266 patients stopped taking drugs within one year after treatment, which was significantly different from other years( χ^(2)=29.78, P<0.05). These main factors for stopping taking drugs were patients′ personal factors(278 cases, 56.50%). The distribution of factors for drug withdrawal was different among the other variables such as marital status, occupation, route of infection, duration of treatment at the time of stopping taking drugs, situation of missed taking drugs, and antiviral treatment within one year after diagnosis(P<0.05). Among these factors affecting the timely retreatment of patients with antiviral treatment, the possibility of retreatment within 6 months after drug withdrawal in non-agricultural occupation was 2.063 times than that of farmers(95% CI: 1.048~4.063), and the possibility of retreatment within 6 months after drug withdrawal due to personal reasons was only 0.414 times than that of drug treatment factors(95% CI: 0.246~0.696). Conclusions: To avoid unnecessary drug withdrawal in HIV/AIDS antiviral treatment, timely retreatment after drug withdrawal is the key factor for the success of treatment. Strengthening the medication compliance education of patients and optimizing the medication plan can reduce the occurrence of drug withdrawal.