重庆市艾滋病抗病毒治疗新入组病人治疗效果及其影响因素分析

目的 了解艾滋病抗病毒治疗病人入组1年时的治疗效果,分析其影响因素,为进一步优化抗病毒治疗措施提供参考依据。方法 采用概率比例抽样法开展现况调查,现场采集病人血样开展病毒载量和CD4+T淋巴细胞检测,并在国家艾滋病防治基本信息系统中收集调查对象抗病毒治疗基线和随访数据。采用Excel 2010建立数据库,运用SPSS19.0进行统计分析。结果 共调查对象389例,病人平均年龄(47.7±16.4)岁,男性占73.3%,已婚占54.8%,异性性接触传播占70.7%,有漏服药物行为的占5.7%。抗病毒治疗1年时,病人病毒学抑制成功比例为94.8%,免疫学成功比例为80.5%,CD4+T值平均增加97(IQR:21～187)个/mm³,艾滋病相关疾病和症状的比例从11.6%下降到4.1%。多因素logistic分析结果显示基线CD4+T值水平、漏服药物行为(无)与病人免疫成功概率相关(P＜0.05),OR值分别为0.29、4.82。结论 重庆市艾滋病抗病毒治疗病人入组1年时的治疗效果显著,为进一步提高病人免疫成功率,建议加强高CD4+ T值水平(≥500个/mm³)、有漏服药物行为的病人知识宣传和依从性教育。

Therapeutic effect and associated factors of HIV/AIDS patients recently starting antiretroviral therapy,Chongqing

Objective To know the therapeutic effect of HIV/AIDS patients having received antiretroviral therapy(ART)for one year,to assess the associated factors of immunology success,and to provide reference for further optimization of ART in Chongqing.Methods The sampling method of probability proportionate to size(PPS)was adopted to conduct survey in this study.The blood samples of patients were collected and used to test viral load and CD4+ T cell counts.Elementary and follow-up databases of patients’ treatment were collected from the national AIDS prevention and control information system.The databases were established by software Excel 2010 and analyzed by SPSS 19.0.Results 389 patients averaged 47.7±16.4 years old were surveyed in this study.73.3% of the patients were male,54.8% were married,70.7% were infected through heterosexual contact,and 5.7% once missed taking their pills.About one year after starting ART,the inhibition rate of viral load was 94.8%,and that of immunology was 80.5%.The CD4+ T cell counts increased 97(IQR:21~187)/mm³,and the proportion of AIDS-related diseases and symptoms decreased from 11.6% to 4.1% after treatment.The multivariate logistic regression analysis indicated that the associated factors of immunology success included CD4+ T cell counts(≥500/mm³)and medicine-taking behavior(never missing taking pills),and the OR values were 0.29 and 4.82,respectively.Conclusion The therapeutic effect of ART starting about one year is remarkable in Chongqing.To enhance the proportion of immunology success,we should strengthen communication of treatment knowledge and improve the adherence education service during treatment for the targeted patients.