基线CD4低于350个/mm^(3)的HIV/AIDS抗病毒治疗免疫学效果及其影响因素分析

Immunological effect and influencing factors of HAART on HIV/AIDS with baseline CD4 below 350 cells/mm^(3)

目的分析湖北省2011—2020年期间基线CD4低于350个/mm^(3)的HIV/AIDS抗病毒治疗的免疫学效果及其影响因素。方法通过中国疾病预防控制信息系统收集HIV/AIDS的信息,利用Wilcoxon符号秩和检验分析CD4均值的变化;利用卡方检验和多因素logistic回归分析影响免疫学效果的因素。结果患者治疗前基线CD4均值为(172.78±107.65)个/mm^(3),治疗后第五年均值为(398.85±206.71)个/mm^(3);基线CD4<50个/mm^(3)的患者治疗后CD4均值增幅最大(P<0.05)。多因素logistic回归分析显示,年龄≥35岁,异性性传播,确诊到治疗的时间间隔≥1个月,基线CD4<50个/mm^(3),治疗时间7~<18个月,有漏服药是抗病毒治疗免疫学成功的危险因素(P<0.05)。结论湖北省HIV/AIDS抗病毒治疗免疫学效果受多种因素影响,应强化早发现早治疗策略的执行,加强年龄≥35岁患者治疗依从性教育。

Objective To analyze the immunological effect and its influencing factors of HAART on HIV/AIDS with a baseline CD4 of less than 350 cells/mm^(3) in Hubei Province during 2011-2020.Methods The treatment information of people living with HIV/AIDS(PLWH)was collected through China Disease Control and Prevention Information System,and the change of CD4 mean value was analyzed by Wilcoxon sign rank sum test.Chi square test and multivariate logistic regression were used to analyze the factors influencing the immunological effect.Results The mean value of CD4 cell count at baseline was(172.78±107.65)cells/mm^(3) before treatment and(398.85±206.71)cells/mm^(3) in the fifth year after treatment.Patients with baseline CD4<50/mm^(3) had the largest increase in CD4 mean value after treatment(P<0.05).Multivariate logistic regression analysis showed that Age≥35 years,heterosexual transmission,time interval from diagnosis to treatment≥1 month,baseline CD4<50/mm^(3),treatment time 7-<18 months,and drug failure were the risk factors for the success of antiviral therapy(P<0.05).Conclusion The immunological effect of HIV/AIDS antiviral therapy in Hubei Province is affected by many factors.It is necessary to strengthen the implementation of early detection and early treatment strategy and promote treatment compliance education for patients aged≥35 years.