德宏傣族景颇族自治州新报告HIV感染者多共病现况研究

Prevalence and associated factors of multimorbidity among newly reported HIV-positive individuals in Dehong Dai and Jingpo Autonomous Prefecture

目的了解云南省德宏傣族景颇族自治州(简称德宏州)新报告HIV感染者多共病患病率及其影响因素。方法 2018年1月1日―2020年6月30日对德宏州新报告HIV感染者进行多共病的横断面研究。多共病指患有≥2种慢性疾病。结果共纳入468例HIV感染者,年龄35~<50岁者258例(55.1%),男女比约为1.4∶1,汉族者199例(42.5%)。多共病者共140例,患病率为29.9%,患有2、3、4、5和6种共病者分别占19.0%、8.3%、1.1%、0.9%和0.6%。患病率前5的共患疾病分别为血脂异常、慢性感染、高血压、贫血和肝纤维化,占比分别为48.9%、15.2%、13.9%、13.0%和8.3%。多因素Logistic回归分析模型分析结果显示,50~77岁年龄组(aOR=4.06,95%CI:1.98~8.33,P<0.001)、曾经吸食或注射毒品(aOR=2.26,95%CI:1.23~4.14,P=0.009)和CD4^(+)T淋巴细胞计数<200个/μl(aOR=2.03,95%CI:1.23~3.37,P=0.006)与多共病之间差异有统计学意义。结论德宏州新报告HIV感染者多共病率较高,尤其是年长、有毒品使用史和低CD4^(+)T淋巴细胞计数水平者共病负担较高,提示HIV常规随访关怀中应考虑纳入多共病的综合监测与管理。

Objective To explore the prevalence and associated factors of multimorbidity among the newly reported human immunodeficiency virus(HIV)-positive individuals in Dehong Dai Jingpo Autonomous Prefecture(Dehong).Methods From 1 January 2018 to 30 June 2020,a cross-sectional study was conducted to investigate the multimorbidity burden among newly reported HIV-positive individuals in Dehong.Multimorbidity was defined as the presence of at least two chronic diseases.Results 468 subjects were included,of which 258(55.1%) were 35-<50 years old,male to female ratio was about 1.4∶1 and 199(42.5%) were Han Chinese.Among them,140(29.9%) had the multimorbidity.The prevalence of having two,three,four,five,six comorbidities were 19.0%,8.3%,1.1%,0.9% and 0.6%,respectively.The top 5 comorbidities were dyslipidemia,chronic infections,hypertension,anemia and liver fibrosis,accounting for 48.9%,15.2%,13.9%,13.0% and 8.3%,respectively.In multivariate Logistic regression,aged ≥ 50 years old(aOR=4.06,95% CI:1.98-8.33,P<0.001),have history of drug abuse or injection drug use(aOR=2.26,95% CI:1.23-4.14,P=0.009) and CD4^(+)T lymphocyte counts <200 cells/μl(aOR=2.03,95% CI:1.23-3.37,P=0.006) were significantly associated with the presence of multimorbidity.Conclusions The prevalence of multimorbidity was high among newly reported HIV-positive individuals in Dehong particularly among the elderly,drug users and those with lower CD4 counts.Our data suggested that monitoring and managing multimorbidity should be integrated into regular HIV care.