Analysis on antiretroviral therapy effect and influencing factors among adult HIV/AIDS patients in Yining
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摘要: 目的 了解伊宁市成人艾滋病病毒感染者/艾滋病患者(human immunodeficiency virus infection and acquired immune deficiency syndrome,HIV/AIDS)抗病毒治疗效果并分析其影响因素。方法 在国家艾滋病抗病毒治疗数据库中收集2005-2015年抗病毒治疗者的治疗信息;采用回顾性研究和Logistic回归方法进行分析。结果 共3 740例艾滋病抗病毒治疗者纳入研究,异性感染和吸毒感染分别占46.3%和32.0%,基线CD4+T淋巴细胞计数为278(170,395)个/μl。治疗满6、12、24、36、60个月时病毒抑制率分别为70.4%(1 568/2 228)、64.4%(1 695/2 631)、66.3%(1 590/2 400)、70.1%(1 345/1 919)和73.6%(550/747),治疗满12个月的病毒抑制率低于其他时间(均有P<0.05)。多因素分析显示药物漏服在治疗满12、36和60个月均为病毒抑制失败的危险因素,调整比值比(AOR)(95%CI)分别为3.581(2.943~4.357)、2.496(1.957~3.182)和3.137(1.969~4.998);在治疗满12个月时,吸毒感染(AOR=1.544,95%CI:1.164~2.048)和基线CD4+T淋巴细胞计数(个/μL)<200(AOR=1.371,95%CI:1.086~1.731)是病毒抑制失败的危险因素。结论 伊宁市抗病毒治疗病毒抑制失败率较高,药物漏服是病毒抑制失败的主要危险因素,需加强吸毒感染及晚期治疗患者的依从性教育和服药指导,提高乡镇级卫生院的诊疗水平,进一步提高治疗效果。Abstract: Objective To analyze the antiretroviral therapy(ART) effect and influencing factors among adult human immunodeficiency virus(HIV)/acquired immune deficiency syndrome (AIDS) patients in Yining. Methods Monitoring data of adult patients receiving ART were collected from the national antiretroviral therapy reporting system. Retrospective study was conducted and Logistic regression method was applied to analyze the influencing factors. Results A total of 3 740 cases were enrolled in this study. Heterosexual infection and drug infection accounted for 46.3% and 32.0%, respectively, the median of baseline CD4+T lymphocyte count was 278(170,395) cells/μl. The virological inhibition rate were 70.4%(1 568/2 228), 64.4%(1 695/2 631), 66.3%(1 590/2 400), 70.1%(1345/1919) and 73.6%(550/747) at 6,12,24,36,60 months after ART, respectively, rate at 12 months was the lowest (all P<0.05). Multivariate analysis showed that in different duration of treatment(12,36 and 60 months after ART), dose missing was the risk factor of virological failure, adjusted odds ratio(AOR) (95% CI) were 3.581(2.943-4.357), 2.496(1.957-3.182) and 3.137(1.969-4.998), respectively. Injecting drug use (AOR=1.544, 95% CI:1.164-2.048) and baseline CD4+T lymphocyte count (cells/μl)<200(AOR=1.371, 95% CI:1.086-1.731) were the risk factors of virological failure at 12 months after ART. Conclusions The rate of virological failure among patients received ART in Yining was high. Dose missing was the main risk factor. The adherence education and dose guidance should be strengthened among patients injecting drug or with lower baseline CD4+T lymphocyte count, and the treat ability in the township treatment institution should be improved to get a better virologic suppression effect.
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Key words:
- HIV /
- Treatment effect /
- Epidemiologic methods
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