天津市2019-2022年新报告HIV感染者抗病毒治疗前病毒载量基线特征分析

Characteristics of baseline viral load before antiretroviral therapy in newly reported HIV-infected patients in Tianjin,2019-2022

目的了解天津市新报告HIV感染者抗病毒治疗前病毒载量(VL)基线特征及相关因素。方法资料来源于中国疾病预防控制信息系统,研究对象为天津市2019-2022年新报告且首次抗病毒治疗前HIV感染者,收集其社会人口学特征、CD4^(+)T淋巴细胞(CD4)计数及VL值等基线信息,基线高VL值定义标准为≥100000拷贝数/ml,分析影响VL水平的相关因素。采用SPSS 24.0软件进行统计学分析。结果研究对象新报告HIV感染者共1296例,其中,基线高VL值的HIV感染者占15.89%(206/1296)。多因素logistic回归分析结果显示,有STD史者(aOR=1.45,95%CI:1.00~2.08),基线高VL值的可能性较大;相比于基线CD4计数<200个/µl者,基线CD4计数分别为200~350个/µl(aOR=0.40,95%CI:0.27~0.57)、351~500个/µl(aOR=0.32,95%CI:0.20~0.49)和>500个/µl者(aOR=0.30,95%CI:0.18~0.49)的基线高VL值的可能性较小。结论2019-2022年天津市HIV感染者抗病毒治疗前基线VL值高的比例较低,HIV感染者基线VL值高的相关因素为有STD史和基线CD4计数<200个/µl,艾滋病防控工作应给予重点关注。

Objective To understand the baseline viral load(VL)of newly reported HIVinfected patients before antiretroviral therapy and related factors in Tianjin.Methods Data were obtained from the China Disease Control and Prevention Information System,and the study subjects were HIV-infected patients before the first antiretroviral therapy in Tianjin from 2019 to 2022,and the information about their socio-demographic characteristics,baseline CD4^(+)T lymphocyte(CD4)counts before antiretroviral therapy and baseline VL test results were collected,the baseline high VL was defined as≥100000 copies/ml.The effect of different factors on viral load were analyzed.Software SPSS 24.0 was used for statistical analysis.Results A total of 1296 newly reported HIV-infected patients were included in the study,in whom 15.89%(206/1296)had high baseline VL,and multifactorial logistic regression analysis showed that those with history of STD(aOR=1.45,95%CI:1.00-2.08)were more likely to have high baseline VL.Compared with those with baseline CD4 counts<200 cells/μl,those with baseline CD4 counts 200-350 cells/μl(aOR=0.40,95%CI:0.27-0.57),351-500 cells/μl(aOR=0.32,95%CI:0.20-0.49),and>500 cells/μl(aOR=0.30,95%CI:0.18-0.49)were less likely to have high baseline VL.Conclusions The proportion of HIV-infected patients with high baseline VL before antiretroviral therapy was low in Tianjin during 2019-2022.History of STD and baseline CD4 counts<200 cells/μl were associated with high baseline VL in HIV-infected patients,to which close attention needs to be paid in AIDS prevention and control.