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安徽省接受抗病毒治疗HIV/AIDS死亡的影响因素
引用本文:戴色莺, 刘爱文, 沈月兰, 程晓莉, 张进, 吴建军, 吴家兵, 邢辉, 阮玉华. 安徽省接受抗病毒治疗HIV/AIDS死亡的影响因素[J]. 中华疾病控制杂志, 2022, 26(12): 1379-1383. doi: 10.16462/j.cnki.zhjbkz.2022.12.003
作者姓名:戴色莺  刘爱文  沈月兰  程晓莉  张进  吴建军  吴家兵  邢辉  阮玉华
作者单位:1.230601 合肥,安徽省疾病预防控制中心艾滋病防治科;;2.230601 合肥,安徽省疾病预防控制中心艾滋病病毒分子与免疫学中心实验室;;3.102206 北京,中国疾病预防控制中心性病艾滋病预防控制中心
基金项目:国家科技重大专项2017ZX10201101
摘    要:目的  了解安徽省接受抗病毒治疗HIV感染者和AIDS病人(简称HIV/AIDS)死亡的影响因素。方法  采用1∶2匹配病例对照研究方法,回顾性收集2010―2019年安徽省接受抗病毒治疗HIV/AIDS的相关信息,采用条件logistic回归分析模型分析HIV/AIDS死亡的影响因素。结果  共调查4 347例HIV/AIDS,其中死亡组1 449例,对照组2 898例。多因素条件logistic回归分析模型分析显示,影响抗病毒治疗HIV/AIDS死亡的危险因素中,发生耐药、最近一次病毒载量≥1 000 copies/mL且未检测耐药、最近一次病毒载量无结果且未检测耐药分别是不耐药的1.75倍(95% CI: 1.22~2.52, P=0.003)、2.26倍(95% CI: 1.69~3.03, P<0.001)、35.27倍(95% CI: 26.54~46.87, P<0.001);30~50岁和≥50岁分别是18~30岁的1.40倍(95% CI: 1.01~1.94, P=0.042)和4.02倍(95% CI: 2.80~5.77, P<0.001);男性是女性的1.37倍(95% CI: 1.08~1.74, P=0.011);注射吸毒传播途径是异性传播途径的6.27倍(95% CI: 2.00~19.61, P=0.002);治疗前WHO临床分期为Ⅲ期/Ⅳ期是Ⅰ期/Ⅱ期的1.41倍(95% CI: 1.12~1.76, P=0.007);治疗前CD4+T淋巴细胞计数<200个/μL是≥350个/μL的1.95倍(95% CI: 1.50~2.54, P<0.001)。结论  耐药、耐药检测、年龄、性别、传播途径、治疗前WHO临床分期、治疗前CD4+T淋巴细胞计数是安徽省接受抗病毒治疗HIV/AIDS发生死亡的影响因素。加强HIV/AIDS的耐药监测对减少艾滋病死亡具有重要意义,应对接受抗病毒治疗的HIV/AIDS及时进行病毒载量和耐药检测。

关 键 词:艾滋病病毒   死亡   影响因素   病例对照研究
收稿时间:2021-09-24
修稿时间:2022-01-22

Influencing factors on the death of HIV/AIDS patients receiving antiretroviral therapy in Anhui Province
DAI Se-ying, LIU Ai-wen, SHEN Yue-lan, CHENG Xiao-li, ZHANG Jin, WU Jian-jun, WU Jia-bin, XING Hui, RUAN Yu-hua. Influencing factors on the death of HIV/AIDS patients receiving antiretroviral therapy in Anhui Province[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2022, 26(12): 1379-1383. doi: 10.16462/j.cnki.zhjbkz.2022.12.003
Authors:DAI Se-ying  LIU Ai-wen  SHEN Yue-lan  CHENG Xiao-li  ZHANG Jin  WU Jian-jun  WU Jia-bin  XING Hui  RUAN Yu-hua
Affiliation:1. Department of AIDS prevention, Anhui Provincial Center for Disease Control and Prevention, Hefei 230601, China;;2. Center Laboratory of HIV Molecular and Immunology, Anhui Provincial Center for Disease Control and Prevention, Hefei 230601, China;;3. National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Abstract:  Objective  To understand the influencing factors on the death of HIV/AIDS patients receiving antiretroviral therapy in Anhui Province.  Methods  A 1 to 2 matched case-control study was conducted to collect the information of HIV/AIDS patients who received antiretroviral therapy in Anhui Province from 2010 to 2019. The conditional logistic regression was used to analyze the risk factors on the death of HIV/AIDS patients.  Results  A total of 4 347 HIV/AIDS patients were investigated, with 1 449 cases in the death group and 2 898 cases in the control group. The multivariate conditional logistic regression result showed that among the death risk factors, drug resistance was 1.75 times (95% CI: 1.22-2.52, P=0.003) than that of non-drug resistance; the latest viral load ≥1 000 copies/mL and non-drug resistance tested results were 2.26 times (95% CI: 1.69-3.03, P < 0.001) than that of non-drug resistance; non-viral load and non-drug resistance tested results were 35.27 times (95% CI: 26.54-46.87, P < 0.001) than that of non-drug resistance; patients who age 30-49 years old was 1.40 times (95% CI: 1.01-1.94, P=0.042) than that of the 18-29 years old, and those age ≥ 50 years old was 4.02 times (95% CI: 2.80-5.77, P < 0.001) that of 18-29 years old; male was 1.37 times (95% CI: 1.08-1.74, P=0.011) than that of female, the transmission route of injecting drug use was 6.27 times (95% CI: 2.00-19.61, P=0.002) than that of heterosexual transmission; WHO clinical stage Ⅲ/Ⅳ before treatment was 1.41 times (95% CI: 1.12-1.76, P=0.007) than that of stage Ⅰ/Ⅱ; CD4+T lymphocyte count < 200 cells/μL before treatment was 1.95 times (95% CI: 1.50-2.54, P < 0.001) that of CD4+≥350 cells/μL before treatment.  Conclusions  Drug resistance, drug resistance test after antiretroviral therapy, age, gender, transmission route, WHO clinical stage before treatment, and CD4+T lymphocyte counts before treatment were the influencing factors of HIV/AIDS death in Anhui Province. Strengthening the monitoring of drug resistance for HIV/AIDS patients is important for reducing AIDS deaths. It is necessary to test viral load and drug resistance in time for HIV/AIDS patients receiving antiretroviral therapy.
Keywords:HIV  Death  Influencing factors  Case-control study
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