山东省1926例经同性传播HIV感染者治疗及时性分析

Immediate antiretroviral treatment in 1,926 cases of HIV infection through homosexual transmission in Shandong Province

目的探讨山东省经同性传播人类免疫缺陷病毒(HIV)感染者抗病毒治疗(ART)及时性的影响因素,为进一步控制HIV的传播流行提供参考依据。方法选取2018年山东省1926例新诊断经同性传播HIV感染者为研究对象,采用回顾性队列研究收集相关资料,采用二分类Logistic回归分析ART及时性的影响因素。结果2018年山东省经同性传播HIV感染者1926例,诊断基线年龄中位数为31.15岁,诊断基线CD4细胞水平中位数为364个/μL,ART及时率为73.94%。户籍为省外的HIV感染者及时接受ART的可能性低于山东省内感染者(OR=0.59,95%CI:0.40~0.87),由羁押人群发现的HIV感染者及时接受ART的可能性低于重点人群(OR=0.25,95%CI:0.11~0.59),诊断基线CD4细胞水平为351~499和≥500个/μL的HIV感染者及时接受ART的可能性低于≤350个/μL者(OR=0.71,95%CI:0.53~0.96;OR=0.50,95%CI:0.38~0.66)。结论需进一步提高山东省经同性传播HIV感染者ART及时率,要特别注意省外户籍、羁押人群及诊断基线CD4细胞水平较高者,使其尽快接受ART,以进一步控制HIV的传播流行。

Objective To explore the influencing factors of immediate antiretroviral therapy(ART)among newly diagnosed cases of HIV infection through homosexual transmission in Shandong Province,so as to provide reference for the control of HIV transmission.Methods A total of 1,926 cases of HIV infection through homosexual transmission in 2018 were selected as the research objects.Related data were collected with retrospective cohort study.The influencing factors of immediate ART were determined with binary Logistic regression.Results The median baseline age at diagnosis was 31.15 years,the diagnostic CD4 cell level at baseline was 364 cells/μL,and the rate of immediate ART was 73.94%.Those with household registration outside Shandong had lower rate of immediate ART than those in the province(OR=0.59,95%CI:0.40-0.87).The detained population had lower immediate ART rate than the key population(OR=0.25,95%CI:0.11-0.59).Patients with baseline CD4 cell level of 351-499 and≥500 cells/μL had lower immediate ART rate than those with≤350 cells/μL(OR=0.71,95%CI:0.53-0.96;OR=0.50,95%CI:0.38-0.66).Conclusion It is necessary to improve the immediate ART rate among newly diagnosed cases of HIV infection through homosexual transmission in Shandong Province.In particular,to control the spread of HIV,due attention should be paid to those with household registration outside the province,the detained population and those with high baseline CD4 cell level.