HIV感染者/AIDS患者衰弱状况及影响因素分析

Frailty status and influencing factors in people living with human immunodeficiency virus infection/acquired immunodeficiency syndrome

目的了解人类免疫缺陷病毒(HIV)感染/艾滋病(AIDS)患者(PLWHA)衰弱现状及其影响因素。方法选取2019年6—8月长沙市某医院≥18岁的PLWHA作为研究对象,采用自行编制的问卷以及蒂尔堡衰弱量表分别评估研究对象的基本情况以及衰弱情况。结果PLWHA衰弱发生率为26.4%,logistics回归分析显示,感染年限>5年的患者发生衰弱的风险为感染年限≤5年患者的2.33倍(95%CI:1.24~4.37,P=0.009);最高HIV载量≥10万拷贝/mL患者发生衰弱的风险为最高HIV载量<10万拷贝/mL患者的1.40倍(95%CI:1.05~1.85,P=0.022);CD4^(+)T淋巴细胞计数<200个/mm 3的患者发生衰弱的风险为CD4^(+)T淋巴细胞计数≥200个/mm 3患者的3.60倍(95%CI:1.96~6.62,P<0.001)。结论HIV感染年限越长、当前CD4^(+)T淋巴细胞计数越低、HIV载量越高的PLWHA更容易发生衰弱。

Objective To investigate the frailty status and influencing factors in people living with human immunodeficiency virus(HIV)infection/acquired immunodeficiency syndrome(AIDS)(PLWHA).Methods PLWHA aged≥18 years in a hospital in Changsha City from June to August 2019 were selected as the study subjects.The basic condition and frailty of the subjects were evaluated by self-designed questionnaire and Tilburg frailty indicator,respectively.Results The incidence of frailty in PLWHA was 26.4%,logistic regression analysis showed that patients with infection years>5 years had a 2.33 times higher risk of frailty compared with patients with infection years≤5 years(95%CI:1.24-4.37,P=0.009).The risk of frailty in patients with a highest HIV load of≥100000 copies/mL was 1.40 times higher than in patients with a highest HIV load of<100000 copies/mL(95%CI:1.05-1.85,P=0.022).The risk of frailty in patients with CD4^(+)T lymphocyte count<200 mm 3 was 3.60 times higher than that in patients with CD4^(+)T lymphocyte count≥200 mm 3(95%CI:1.96-6.62,P<0.001).Conclusion PLWHA with longer duration of HIV infection,lower CD4^(+)T lymphocyte count and higher HIV load are more prone to develop frailty.