云南省德宏州接受抗病毒治疗的HIV感染者多病共患情况分析

Prevalence of multimorbidity among the HIV-infected individuals receiving anti-viral therapy in Dehong Prefecture,Yunnan Province

【目的】了解云南省德宏州接受抗病毒治疗(ART)的人类免疫缺陷病毒(HIV)感染者多病共患情况及影响因素,为HIV感染者长期随访管理和慢性病综合防治提供参考。【方法】于2021年1—7月采用自行设计的问卷对德宏州接受ART的成年HIV感染者展开横断面调查,分析相关患病指标,使用多因素logistic回归模型分析影响因素。【结果】共纳入研究对象3946人,年龄以≤50岁(63.7%)者为主,男女比1.1∶1。其中,共有825例接受ART的HIV感染者有≥2种共患病,共患率为20.9%(95%CI:19.6%~22.2%),主要共患病为血脂异常、糖尿病、高血压。多因素logistic回归模型分析结果显示,年龄40~<50岁(aOR=1.86,95%CI:1.45~2.40,P<0.001)、年龄50~85岁(aOR=3.75,95%CI:2.93~4.80,P<0.001)、傣族(aOR=1.21,95%CI:1.01~1.47,P=0.043)、BMI≥24.0 kg·m^(-2)(aOR=1.79,95%CI:1.49~2.14,P<0.001)、ART时长为10.0~<12.5年(aOR=1.49,95%CI:1.05~2.12,P=0.024)、ART时长≥12.5年(aOR=1.50,95%CI:1.05~2.15,P=0.026)、使用二线治疗方案(aOR=1.43,95%CI:1.19~1.70,P<0.001)和其他治疗方案(aOR=3.16,95%CI:2.17~4.61,P<0.001)与多病共患呈正相关。【结论】德宏州接受ART的HIV感染者多病共患率较高,与年龄增长、患病治疗时间长相关,尤以血脂异常、糖尿病、高血压共病负担较高。未来需针对性加强共病的综合监测与ART随访管理。

[Objective]To explore the prevalence and influencing factors of multimorbidity among the HIV-infected individuals receiving antiviral therapy(ART)in Dehong Prefecture of Yunnan Province,so as to provide a reference for the long-term follow-up management of HIVinfected patients and the comprehensive prevention and treatment of chronic diseases.[Methods]A cross-sectional study was conducted to investigate the multimorbidity burden among the HIV-infected adults receiving ART in Dehong Prefecture from January to July 2021 and a selfdesigned questionnaire was used to analyze relevant disease indicators.Multivariate logistic regression analysis was used to investigate the influencing factors of multimorbidity among the HIV-infected individuals.[Results]A total of 3946 HIV-infected individuals receiving ART were enrolled in this study,of which 63.7%aged≤50 years,with a male to female ratio of 1.1∶1.Among the 3946 cases,825 of them had≥2 comorbidities,with a co-prevalence rate of 20.9%(95%CI:19.6%‒22.2%),and the main comorbidities were dyslipidemia,diabetes,and hypertension.Multivariate logistic regression analysis showed that 40≤aged<50 years(aOR=1.86,95%CI:1.45‒2.40,P<0.001),50≤aged≤85 years(aOR=3.75,95%CI:2.93‒4.80,P<0.001),Dai nationality(aOR=1.21,95%CI:1.01‒1.47,P=0.043),BMI≥24.0 kg∙m^(−2)(aOR=1.79,95%CI:1.49‒2.14,P<0.001),10.0≤with ART duration for<12.5 years(aOR=1.49,95%CI:1.05‒2.12,P=0.024),with ART duration for≥12.5 years(aOR=1.50,95%CI:1.05‒2.15,P=0.026),use of second-line HIV therapy(aOR=1.43,95%CI:1.19‒1.70,P<0.001)and other therapy options(aOR=3.16,95%CI:2.17‒4.61,P<0.001)were positively correlated with multimorbidity.[Conclusion]The prevalence of multimorbidity among the HIV-infected individuals receiving ART in Dehong Prefecture is high,which is associated with the advancing age and prolonged treatment time,particularly with a significant burden of dyslipidemia,diabetes,and hypertension.Comprehensive surveillance and targeted management of comorbidities,along with ART follow-up,need to be strengthened in the future.