广州地区艾滋病自费药物抗病毒治疗现状研究

The current situation of self-paid antiretroviral treatment for HIV patients in Guangzhou

目的了解广州地区抗病毒治疗(ART)HIV感染者人群的自费药物服药现状,为个性化的患者随访管理提供理论依据。方法收集2019年5月至2020年8月广州地区艾滋病门诊接受自费ART治疗的290例HIV感染者的信息,对人口学特征、感染情况、自费药物相关情况、心理健康状况进行分析,并比较初治患者和经治患者的特征差异。结果290例HIV感染者中,以男性为主(269例,92.76%),年龄为(37.56±12.85)岁。因各种原因将国产免费药物改为自费药物的经治患者169例,初治使用自费药物患者121例。使用自费药物原因、CD4+T淋巴细胞水平、确诊到自费ART年限、计划使用自费药物时长、愿意定期复诊在初治组与经治组间比较差异存在统计学意义(χ^(2)=29.79、35.99、110.29、20.38和5.82,P=0.019、<0.001、<0.001、<0.001和=0.016)。经治患者焦虑发生率为18.93%(32/169),低于初治患者(χ^(2)=5.33,P=0.021)。结论初治CD4+T淋巴细胞水平低的患者更倾向选择自费药物。不同治疗阶段患者选用自费药物的关注点不同,初治患者应重点关注心理状况及使用药物的可持续性,而经治患者侧重于关注治疗依从性。

Objective To understand the medication status of HIV patients undergoing self-paid antiretroviral treatment(ART)in Guangzhou,so as to provide the theoretical basis for individualized follow-up management.Methods The data of 290 HIV patients who received self-paid ART treatment in AIDS clinics of Guangzhou from May 2019 to August 2020 were collected.The demographics,infection status,self-paid drugs,and mental health status of these patients were analyzed.The characteristics between newly treated patients and previously treated patients were compared.Results Of the 290 HIV patients,the majority were males(269 cases,92.76%),and the age was(37.56±12.85)years old.There were 169 previously treated patients who changed from free drugs to self-paid drugs for various reasons,and the rest 121 patients were initially treated by self-paid drugs.On comparing the newly treated and previously treated patients,significant differences were observed in reasons for using self-paid drugs,CD4+T cell levels,years from diagnosis to self-paid ART,duration of self-paid drug application,adhere to follow-up regularly(χ^(2)=29.79,35.99,110.29,20.38 and 5.82,P=0.019,<0.001,<0.001,<0.001 and=0.016).The incidence of anxiety in previously treated patients was 18.93%(32/169),which was lower than that in newly treated patients(χ^(2)=5.33,P=0.021).Conclusions Newly treated patients with low level of CD4+T cells prefer to choose self-paid drugs.Patients at different treatment stages may have different concerns for self-paid drugs.The newly treated patients should focus on their psychological status and the sustainability of medication,while the previously treated patients should focus on treatment compliance.