广东省艾滋病免费抗病毒治疗维持状况调查

目的：调查广东省艾滋病免费抗病毒治疗的维持状况，探讨影响病人治疗维持时间的因素。方法：利用国家统一的成人DataFax抗病毒治疗信息数据库，收集全省1307名接受抗病毒治疗病人的资料，采用COX比例风险模型，对影响抗病毒治疗的维持时间之因素进行分析。结果：2004年10月至2008年5月全省共免费治疗1307名病人，其中66．7％病人在出现艾滋病相关症状后才被检测出HIV阳性；52．3％开始治疗时已经进入临床Ⅲ期；29．9％进入了临床Ⅳ期。88．2％的人开始治疗时CD4^＋T细胞低于200个／μL；结束治疗病人中，88．9％维持治疗时间小于1年，维持治疗时间最长的达到3年，影响病人维持治疗时间的主要因素是漏服次数、更换方案次数、治疗开始时CD4^＋T细胞水平、静脉吸毒感染。结论：应采取措施尽量延长病人治疗时间，加强对患者特别是静脉吸毒者的服药依从性教育，及时监测病人的服药情况，必要时及时调整方案。

Analysis of Factors Relating to the Sustain Length of AIDS Antiretroviral Therapy in Guangdong

Objective：To explore the situation of AIDS antiretroviral therapy in Guangdong, analysis the factors relating to the sustain time of ARV. Methods ： he data of antiretroviral therapy over the province were collected by the DataFax antiretroviral therapy information searching system commonly used in China, there were 1307 cases were analyzed. Cox regression analysis was employed for the data to analysis the factors relating to the sustain time of ARV. Results： There were 1307 patients were treated from Oct 2004 to May 2008, 66.7% patients were diagnosed as HIV after they AIDS related symptom emerged;52.3% patients come into clinical phase Ⅲ and 29.9% patients come into clinical phase Ⅳ when they began to receive ART. 88.2% patients had a CD4 ＋T cell count lower than 200, 88.9% patients sustain therapy less than one year among those terminated patients ; the longest sustain time of ART was 3 years after the ART implementation in 2004; the main factors to the sustain time of ARV was the times of failure to take bills, immediate adoption of alternative drugs, CD4 ＋ T cell level at the beginning of therapy, drug using by artery. Conclusion ： It＇ s needed to take measures to extend the sustain time of ARV. Education should be strengthened among AIDS patients to improve their compliance with treatment regime and a system to monitor the adverse reaction of ARV drugs and drug taking should be established so that alternative drugs could be used timely whenever it＇ s necessary. Only by adopting all these measures in a proper way, can the antiretroviral therapy be sustained longer.