天津市2016-2020年新报告HIV/AIDS患者抗病毒治疗及时性分析

Analyse the timeliness of initiationanti-retroviral treatment among newly diagnosed HIV/AIDS cases in Tianjin,2016-2020

目的了解天津市新报告HIV/AIDS患者及时启动ART情况,分析相关影响因素。方法通过艾滋病防治基本信息系统,收集天津市2016-2020年新报告的HIV/AIDS患者相关信息,采用单因素和多因素Logistic回归分析探讨ART及时性影响因素。结果2016-2020年,天津市新报告HIV/AIDS患者3281例,68.7%及时接受ART。2016-2020年各年及时治疗比例分别为61.2%、68.8%、63.9%、72.4%和77.4%,不同年份之间差异有统计学意义(χ^(2)_(趋势)=50.955,P=0.000)。多因素分析结果显示年龄30~39岁(OR=1.531,95%CI:1.228~1.909)、40~49岁(OR=1.545,95%CI:1.140~2.094)、本市户籍(OR=1.427,95%CI:1.199~1.697)、高中及以上文化程度(OR=1.271,95%CI:1.053~1.535)、本市报告(OR=1.542,95%CI:1.147~2.072)研究对象及时ART的概率高。异性性传播(OR=0.780,95%CI:0.624~0.975)、注射毒品传播(OR=0.184,95%CI:0.063~0.534)、来源于羁押人员检测(OR=0.143,95%CI:0.073~0.281)、术前及临床可疑检测(OR=0.588,95%CI:0.396~0.873)、检测咨询(OR=0.728,95%CI:0.554~0.956)、无偿献血人员检测(OR=0.583,95%CI:0.373~0.655)、首次CD4细胞计数>200个/μL的患者及时接受ART的概率低。结论天津市新报告HIV/AIDS患者及时接受ART的比例较高,要加强低年龄组、外地户籍、文化程度较低、异性性传播及注射毒品传播、来源于羁押人员检测、术前及临床可疑检测、检测咨询、无偿献血人员检测、首次CD4细胞计数较高、外地报至天津市的患者的随访与转介治疗,以进一步提高及时治疗比例。

Objective To study the situation of timely initiationanti-retroviral treatment and influencing factors after HIV/AIDS cases tested in Tianjin.Methods The data of the HIV/AIDS cases who were tested between 2016 and 2020 in Tianjin were collected from Chinese HIV/AIDS Basic Information Management System.While univariate and multivariate logistic regression analysis were used to identify the factors associated with timely initiation of antiretroviraltreatment.Results 3281 HIV/AIDS cases were included,among them 68.7%initiated anti-retroviral treatment timely.Multivariate logistic regression analysis showed thatthe cases aged 30-39 years(OR=1.531,95%CI:1.228-1.909),40-49 years(OR=1.545,95%CI:1.140-2.094),who were the local residents(OR=1.427,95%CI:1.199-1.697),with high middle school degree or above(OR=1.271,95%CI:1.053-1.535),Tianjin reported(OR=1.542,95%CI:1.147-2.072)have the higher proportion of timelyinitiated anti-retroviral treatment.While the cases infected from heterosexual transmission(OR=0.780,95%CI:0.624-0.975)and injecting drug transmission(OR=0.184,95%CI:0.063-0.534),coming from detection among prisoners(OR=0.143,95%CI:0.073-0.281),detectionbefore operation(OR=0.588,95%CI:0.396-0.873),VCT(counseling and testing,OR=0.728,95%CI:0.554-0.956)and detection among Voluntary Blood Donor(OR=0.583,95%CI:0.373-0.655),have the lower proportion of timelyinitiated anti-retroviral treatment.Conclusions There is a high proportion of timely initiationanti-retroviral treatment among HIV/AIDS cases newly tested in Tianjin.We should strengthen the work among the cases with low age,not local residents,low education degree,infected from heterosexual transmission and injecting drug transmission,tested from detection among prisoners,detection before operation,VCT(counseling and testing)and detection among Voluntary Blood Donor,with the high first CD4+T lymphocyte count and other provinces reported to Tianjin,so as to increase the proportion of timely initiationanti-retroviral treatment further.