德宏傣族景颇族自治州新报告HIV感染者多共病现况研究

  目的  了解云南省德宏傣族景颇族自治州(简称德宏州)新报告HIV感染者多共病患病率及其影响因素。  方法  2018年1月1日―2020年6月30日对德宏州新报告HIV感染者进行多共病的横断面研究。多共病指患有≥2种慢性疾病。  结果  共纳入468例HIV感染者，年龄35~ < 50岁者258例(55.1%)，男女比约为1.4∶1，汉族者199例(42.5%)。多共病者共140例，患病率为29.9%，患有2、3、4、5和6种共病者分别占19.0%、8.3%、1.1%、0.9%和0.6%。患病率前5的共患疾病分别为血脂异常、慢性感染、高血压、贫血和肝纤维化，占比分别为48.9%、15.2%、13.9%、13.0%和8.3%。多因素Logistic回归分析模型分析结果显示，50~77岁年龄组(aOR=4.06, 95% CI: 1.98~8.33, P < 0.001)、曾经吸食或注射毒品(aOR=2.26, 95% CI: 1.23~4.14, P=0.009)和CD4+T淋巴细胞计数＜200个/μl(aOR=2.03, 95% CI: 1.23~3.37, P=0.006)与多共病之间差异有统计学意义。  结论  德宏州新报告HIV感染者多共病率较高，尤其是年长、有毒品使用史和低CD4+T淋巴细胞计数水平者共病负担较高，提示HIV常规随访关怀中应考虑纳入多共病的综合监测与管理。

Prevalence and associated factors of multimorbidity among newly reported HIV-positive individuals in Dehong Dai and Jingpo Autonomous Prefecture

  Objective  To explore the prevalence and associated factors of multimorbidity among the newly reported human immunodeficiency virus (HIV)-positive individuals in Dehong Dai Jingpo Autonomous Prefecture (Dehong).  Methods  From 1 January 2018 to 30 June 2020, a cross-sectional study was conducted to investigate the multimorbidity burden among newly reported HIV-positive individuals in Dehong. Multimorbidity was defined as the presence of at least two chronic diseases.  Results  468 subjects were included, of which 258 (55.1%) were 35- < 50 years old, male to female ratio was about 1.4∶1 and 199 (42.5%) were Han Chinese. Among them, 140 (29.9%) had the multimorbidity. The prevalence of having two, three, four, five, six comorbidities were 19.0%, 8.3%, 1.1%, 0.9% and 0.6%, respectively. The top 5 comorbidities were dyslipidemia, chronic infections, hypertension, anemia and liver fibrosis, accounting for 48.9%, 15.2%, 13.9%, 13.0% and 8.3%, respectively. In multivariate Logistic regression, aged ≥ 50 years old (aOR=4.06, 95% CI: 1.98-8.33, P < 0.001), have history of drug abuse or injection drug use (aOR=2.26, 95% CI: 1.23-4.14, P=0.009) and CD4+T lymphocyte counts < 200 cells/μl (aOR=2.03, 95% CI: 1.23-3.37, P=0.006) were significantly associated with the presence of multimorbidity.  Conclusions  The prevalence of multimorbidity was high among newly reported HIV-positive individuals in Dehong particularly among the elderly, drug users and those with lower CD4 counts. Our data suggested that monitoring and managing multimorbidity should be integrated into regular HIV care.