山东省潍坊市HIV/AIDS患者抗病毒治疗及时性及影响因素分析

Analysis on timeliness of antiretroviral treatment and influencing factors of HIV/AIDS patients in Weifang city,Shandong province

目的了解山东省潍坊市艾滋病病毒感染者/艾滋病(HIV/AIDS)患者及时启动高效抗逆转录病毒治疗(ART)情况,分析影响因素,为提高ART及时性提供依据。方法通过艾滋病综合防治基本信息系统,收集2006-2021年山东省潍坊市正在接受ART的HIV/AIDS患者人口学特征、治疗相关信息,采用单因素和多因素logistic回归分析影响ART及时性的相关因素。结果山东省潍坊市1509例正在接受ART的HIV/AIDS患者中,45.1%为及时ART,中位启动时间10(5~18)d。2006-2021年各年及时治疗率呈增长趋势(χ^(2)=-15.705,P<0.001)。多因素分析结果显示,年龄30~39岁(OR=2.16,95%CI:1.65~2.83)、40~49岁(OR=2.92,95%CI:2.14~3.97)、≥50岁(OR=2.92,95%CI:2.14~3.97)、汉族(OR=3.90,95%CI:1.58~9.67)、已婚有配偶(OR=1.73,95%CI:1.36~2.20)、离异或丧偶(OR=1.67,95%CI:1.20~2.34)、样本来源于医疗机构检测(OR=2.34,95%CI:1.47~3.75)和自愿咨询检测(OR=1.99,95%CI:1.25~3.19)、同性性传播(OR=2.11,95%CI:1.14~3.91)、在治疗前3个月内出现症状和疾病(OR=1.63,95%CI:1.13~2.36)、基线CD4细胞计数≤200个/μL(OR=1.54,95%CI:1.11~2.14)是HIV/AIDS患者及时ART的影响因素(P<0.05)。结论山东省潍坊市HIV/AIDS患者及时接受ART的比例较低,年龄、民族、婚姻、传播途径、检测发现途径、出现疾病症状以及基线CD4细胞计数是影响HIV/AIDS患者ART及时性的因素。

Objective To understand the situation of timely initiationanti-retroviral treatment,and analyze the influencing factors of HIV/AIDS cases in Weifang city,so as to provide scientific basis for improving the timeliness of treatment.Methods The data of the HIV/AIDS cases in Weifang city were collected from Chinese HIV/AIDS Basic Information Management System.Univariate and multivariate logistic regression analysis were used to identify the factors associated with timely initiation of antiretroviral treatment.Results There were 1509 HIV/AIDS cases who had received antiviral treatment by the end of 2021 in Weifang city,among them 45.1%initiated anti-retroviral treatment timely,of which the median interval time was 10 days(5-18 days).Multivariate logistic regression analysis showed that the cases aged 30-39 years(OR=2.16,95%CI:1.65-2.83),40-49 years(OR=2.92,95%CI:2.14-3.97),over 50 years old(OR=2.92,95%CI:2.14-3.97),who were the Han nationality(OR=3.90,95%CI:1.58-9.67),with married(OR=1.73,95%CI:1.36-2.20)and divorced or widowed(OR=1.67,95%CI:1.20-2.34),coming from diagnosed in medical institutions(OR=2.34,95%CI:1.47-3.75)and voluntary counseling and testing(OR=1.99,95%CI:1.25-3.19),the cases infected from homosexual transmission(OR=2.11,95%CI:1.14-3.91),combined symptoms and diseases in cases 3 mouths prior to treatment(OR=1.63,95%CI:1.13-2.36)and the baseline CD4^(+)T lymphocyte count≤200/μl(OR=1.54,95%CI:1.11-2.14)had the higher proportion of timely initiated anti-retroviral treatment(P<0.05).Conclusion There is a low proportion of timely initiationanti-retroviral treatment among HIV/AIDS cases in Weifang city.Age,ethnic groups,marriage,transmission route,detection pathway,onset of disease symptoms,and baseline CD4 cell count are factors that affect the timeliness of ART in HIV/AIDS patients.