2019—2020年云南德宏傣族景颇族自治州境内新报告缅甸籍HIV感染者首次CD4^(+)T淋巴细胞计数的临床意义

Clinical implications of first CD4^(+)T cell counts among newly reported HIV-infected Burmese in Dehong Prefecture of Yunnan Province in 2019 and 2020

【目的】了解德宏傣族景颇族自治州(简称“德宏州”)境内2019―2020年新报告缅甸籍人类免疫缺陷病毒(HIV)感染者的一般人口学特征和高危行为,以及首次CD4^(+)T淋巴细胞(简称“CD4细胞”)计数水平。【方法】对德宏州2019―2020年新报告的境内缅甸籍HIV感染者进行横断面调查,收集相关信息并检测其首次CD4细胞计数。【结果】共调查1228例缅甸籍HIV感染者,其中男846例(68.9%),女382例(31.1%);来自克钦邦445例(36.2%)、掸邦210例(17.1%)。所有调查对象中,有960例(78.2%)参加了首次CD4细胞计数检测,405例(42.2%)首次CD4细胞计数<350个·μL^(-1)。多因素logistic回归分析显示:年龄≥30岁(OR=1.44,95%CI:1.07~1.92)和在缅甸境内有共针吸毒史(OR=0.41,95%CI:0.21~0.79)是首次CD4细胞计数<350个·μL^(-1)的影响因素。【结论】德宏州境内新报告缅甸籍HIV感染者首次CD4细胞计数水平总体较低,尤其是年龄≥30岁和在缅甸境内有注射吸毒史的HIV感染者,应尽早发现境内缅甸籍HIV感染者并及时纳入综合管理。

[Objective]To investigate the demographic characteristics,high-risk behavior and first CD4^(+)T cell(CD4 cell)counts among newly reported HIV-infected Burmese in Dehong Dai Jingpo Autonomous Prefecture(Dehong Prefecture)from 2019 to 2020.[Methods]A crosssectional survey was conducted among newly reported HIV-infected Burmese cases in Dehong Prefecture from 2019 to 2020 to collect related information and measure their first CD4 cell counts.[Results]Among 1228 HIV-infected Burmese cases,846(68.9%)were males and 382(31.1%)were females;445(36.2%)were from Kachin,and 210(17.1%)were from Shan.Of them,960 cases(78.2%)had participated in the first CD4 cell counts testing,and 405 cases(42.2%)had a first CD4 cell counts<350 cells·μL^(-1).In the multivariable logistic regression analysis,age≥30 years(adjusted OR=1.44,95%CI:1.07‒1.92)and history of illicit drug use in Myanmar(adjusted OR=0.41,95%CI:0.21‒0.79)were independently associated with first CD4 cell counts<350 cells·μL^(-1).[Conclusion]The first CD4 cell counts are generally low among newly reported HIV-infected Burmese in Dehong Prefecture,especially those aged≥30 years and with a history of intravenous drug use in Myanmar.Therefore,early detection of HIV infection should be strengthened for timely intervention and treatment management among Burmese.