2006 - 2017年玉溪市新报告HIV/AIDS病例的晚发现特征分析

目的 了解2006 - 2017年玉溪市新报告艾滋病病毒感染者/艾滋病病人的晚发现特征及其影响因素。方法 利用艾滋病综合防治数据信息系统中的病例报告卡数据库和随访数据库，以及历年CD4+ T 淋巴细胞检测原始记录进行统计分析。结果 2006 - 2017年玉溪市新发现HIV/AIDS病例2 132例，历年检测份数占当年总人口的比例由2006年的3.33%上升至2017年的31.81%（χ2 = 9 840.375，P＜0.001），晚发现比例由2006的16.28%上升到2017年的17.99%；截止2018年3月，457例晚发现病例中死亡的占30.85%。多因素 Logistic 回归分析显示，男性（OR = 1.280，95%CI:1.020～1.605)，相对于18～30岁年龄组，年龄为31～40（OR = 1.841，95%CI:1.343～2.523）,41～50(OR = 3.585，95%CI:2.506～5.129)，50岁以上(OR = 2.899，95%CI:1.974～4.255)，相对于婚检和孕检，样本来源于医疗机构（OR = 2.887， 95%CI:1.921～4.337)、自愿咨询检测（OR = 1.704，95%CI:1.109～2.618)等是晚发现的危险因素。结论 需要继续扩大HIV抗体筛查面以更早的发现患者，对于晚发现的AIDS病例，应及时提供抗病毒治疗，提高治疗和预防服务质量，避免死亡。

Analysis on the situation of late diagnosis and relevant impact factors of newly reported HIV cases in Yuxi prefecture from 2006 to 2017

Objective To understand the situation of late diagnosis, the death and relevant impact factors of newly reported HIV cases in Yuxi prefecture from 2006 to 2017. Methods Date collected with the HIV/AIDS Case Reporting Cards, Follow-up Cards and original record by the end of March 2018, late diagnosed cases were defined by baseline CD4+ T cell counts. Results There were 2132 cases newly diagnosed in Yuxi prefecture from 2006 to 2017, The proportion of tested number among total population increased from 3.33% in 2006 to 31.81% in 2017 (χ2=9840.375, P<0.001) while the proportion of late diagnosed showed an upward trend year after year (χ2=109.455, P<0.001) before 2013 and then decreased to 17.99% in 2017. Among 457 late diagnosed case 30.85% of them dead by March 2018, there had shorter life time and faster death in late diagnosed case. Multiple Logistic regression analysis indicated that HIV cases who were being male (OR=1.280, 95%CI: 1.020-1.605), 31-40 years old (OR=1.841, 95%CI: 1.343-2.523),41-50 years old (OR=3.585, 95%CI: 2.506-5.129), greater than 50 years old (OR=2.899, 95%CI:1.974-4.255) , diagnosed through hospital setting (OR=2.887, 95%CI:1.921-4.337) and voluntary counseling and testing setting(OR=1.704, 95%CI:1.109-2.618) were likely to be late diagnosed with HIV. Conclusion The HIV screening should be strengthened to find out HIV/AIDS cases earlier, high quality HAART treatment and prevention service should be offer to late diagnosis cases timely to avoid death.