云南省成人AIDS病人抗病毒治疗的疗效分析

目的评估云南省成人艾滋病病人国家免费抗病毒治疗的疗效。方法采用横断面调查的方法,分析云南省各级定点医疗机构,从2001年1月1日至2012年12月31日,接受国家免费抗病毒治疗的AIDS病人的资料,包括人口学资料、基线CD4＋T淋巴细胞（CD4）计数和病毒载量（VL）。结果在治病人病毒抑制率未随治疗时间延长而降低;女性病毒抑制效果好于男性（P〈0.01）;因静脉注射毒品感染艾滋病病毒（HIV）的病人病毒抑制率低于其他途径感染的人群（P〈0.01）;基线CD4〈100个/μL的病人其病毒抑制率显著高于CD4〉100个/μL的病人;30岁以上病人病毒抑制率好于30岁以下者;未婚病人的病毒抑制率比其他婚姻状况（包括已婚、同居、离异或分居等）的人群差。结论云南省艾滋病病人抗病毒治疗效果情况整体较好,但需要加强对于男性、未婚、30岁以下、吸毒感染,以及基线CD4〉100个/μL病人的依从性教育,及时做好VL检测和评估、耐药筛查等工作;基线CD4〉350个/μL的病人,加强治疗管理可以保证治疗效果。

Effectiveness analysis on antiretroviral therapy among HIV infected adults in Yunnan

Objective To evaluate the effectiveness of national free human immunodeficiency virus（HIV）antiretroviral therapy（ART）program in Yunnan.Method Collecting and analyzing the data including demography characteristics,CD4baseline count and virus load of all patients with ART from Jan.1,2001to Dec.31,2012from Yunnan health facilities by the approach of cross-sectional survey.Results The percentage of viral suppression did not decrease as the ART length increased among the ART patients;viral suppression effect was better in the female group than in the male group（P〈0.01）;the proportion of viral suppression in drug use patients was lower than those infected through other routs;the proportion of viral suppression of baseline CD4100copies/μL was higher than that of CD4100copies/μL;the proportion of viral suppression among patients above 30-year-old was higher than the younger people;the proportion of viral suppression among unmarried patients was lower than that of married,cohabited,divorced,separated,etc.Conclusion In general,the effectiveness of ART in Yunnan is satisfied.The adherence education should be strengthened among males,unmarried,younger than 30-year-old patients,drug users,baseline CD4count100copies/μL patients.Viral load testing and evaluation as well as the drug resistance surveillance should be conducted timely.For the patients with baseline CD4350copies/μL,the good consequence can be guaranteed through effective management.