柳州市女性HIV/AIDS抗病毒治疗后CD4变化情况及其影响因素研究

目的 了解柳州市女性人类免疫缺陷病毒携带者/艾滋病（human immunodeficiency virus carriers/acquired immune deficiency syndrome，HIV/AIDS）患者抗病毒治疗现状，探讨抗病毒治疗后CD4变化的影响因素，为今后改善该人群抗病毒治疗效果提供了理论依据。方法 采用横断面研究的方法，在2016年10月~2017年1月间，对柳州市接受病毒治疗的女性HIV/AIDS进行问卷调查，收集患者的相关信息和CD4计数情况，采用多因素有序Logistic回归模型对其抗病毒治疗后CD4计数变化的影响因素进行分析。结果 428名女性HIV/AIDS患者接受抗病毒治疗后12月CD4计数水平明显增加（Z=-16.596，P<0.001），配偶/固定性伴性行为（OR=1.465，95% CI：1.009~2.128，P=0.045）是抗病毒治疗后CD4变化的保护因素，吸食/注射毒品（OR=0.063，95% CI：0.007~0.547，P=0.012）、抑郁分级、治疗前合并机会性感染（OR=0.423，95% CI：0.281~0.636，P<0.001）、治疗前合并肺结核（OR=0.334，95% CI：0.179~0.622，P=0.001）是抗病毒治疗后CD4变化的危险因素。结论 本研究结果显示抗病毒治疗12月后CD4计数水平明显增加，同时表明了促进配偶/固定性伴性行为，改变不良生活行为，改善心理健康状况，积极治疗AIDS相关疾病或感染可能有效的改善抗病毒治疗效果。

Influencing factors of CD4+ T-cell counts changes among female HIV/AIDS patients after highly active antiretroviral treatment in Liuzhou

Objective To understand the status of antiretroviral treatment for female human immunodeficiency virus/acquired immune deficiency syndrome(HIV/AIDS) patients and analyze the influencing factors that affect the CD4 change after antiretroviral therapy (ART), so as to provide theoretical basis for improving the antiviral treatment effect of this group in the future.Methods A cross sectional study was conducted among female HIV/AIDS patients, selected from October 2016 to January 2017. Female patients were interviewed by questionnaire and related data was recorded from The Comprehensive Prevention and Control System of AIDS in China. A model of ordinal logistic regression was performed to analyze the factors that affect CD4 changes after HAART.Results 428 female HIV/AIDS patients received an significant average increase of CD4 count (Z=-16.596, P<0.001). Having sex with spouse or regular sexual partners (OR=1.465, 95% CI:1.009-2.128, P=0.045) was a protective factor for CD4 increases, using illicit drug (OR=0.063, 95% CI:0.007-0.547, P=0.012), depression, opportunistic infection (OR=0.423, 95% CI:0.281-0.636, P<0.001) and tuberculosis (OR=0.334, 95% CI:0.179-0.622, P=0.001) before ART were high risk factors for CD4 increases.Conclusions The results of this study indicated that the levels of CD4 in female HIV/AIDS patients increased significantly after ART. Promoting sexual behavior with spouse/regular partners, removing the bad life behavior, improving the mental health status, treating AIDS-related diseases and infections may effectivey improve the effect of ART.