六安市抗病毒治疗HIV/AIDS患者低病毒血症发生情况及影响因素分析

doi:10.12183/j.scjpm.2024.1109

摘要/Abstract

摘要： 目的分析六安市抗病毒治疗HIV/AIDS患者低病毒血症（LLV）发生影响因素,以及和病毒抑制失败（VF）的关联,为预防LLV的发生提供依据。方法采用回顾性队列研究方法,从中国疾病预防控制信息系统下载六安市抗逆转录病毒治疗（ART）数据库,选取2006—2023年接受ART、年龄≥16岁、ART时长≥6个月的患者作为调查对象,对患者的人口学特征和ART情况进行描述性分析,采用logistic回归模型分析患者发生LLV的影响因素,Kaplan-Meier生存曲线分析LLV和VF的关联。结果共纳入1 834例调查对象,LLV发生率为24.21%（444例）,其中低水平LLV（LLLV）发生率为15.87%（291例）,中等水平LLV（MLLV）发生率为4.20%（77例）,高水平LLV（HLLV）发生率为4.14%（76例）;不同水平LLV患者VF发生率比较差异有统计学意义（P<0.05）;现治疗地区[金安区（OR=3.017）、叶集区（OR=3.075）、舒城县（OR=3.473）],感染途径[同性传播（OR=0.382）、异性传播（OR=0.504）],治疗过程中更换治疗方案（OR=1.854）,基线CD4+T淋巴细胞计数<200个/μL（OR=1.642）,治疗年限为1~5年（OR=0.660）是发生LLV的影响因素。结论六安市HIV/AIDS患者LLV发生的风险较高,且会增加VF发生的风险。基线CD4 +T淋巴细胞计数<200个/μL、治疗过程中更换方案等是LLV发生的危险因素,应尽早进行规范抗病毒治疗,同时提高患者治疗管理质量。

关键词: HIV/AIDS患者, 低病毒血症, 病毒抑制失败, 影响因素

Abstract: Objective To analyze the influencing factors of low-level viraemia (LLV) and its relationship with virus inhibition failure (VF) in HIV/AIDS patients undergoing antiretroviral therapy (ART) in Lu'an City, and to provide the evidence for the prevention of LLV. Methods A retrospective cohort study design was utilized, the ART database of the Lu'an City was obtained from the China Disease Control and Prevention Information System. HIV/AIDS patients who underwent ART, aged ≥16 years, and had an ART duration≥6 months between 2006 and 2023 were selected as the study subjects. Descriptive analysis was used to examine demographic characteristics and ART status, while a logistic regression model was employed to analyze the influencing factors of LLV. Additionally, a Kaplan-Meier survival curve was utilized to assess the association between LLV and VF. Results A total of 1 834 respondents were included in the analysis. The incidence of LLV was found to be 24.21% (444 cases), comprising 15.87% (291 cases) with low-level LLV (LLLV), 4.20% (77 cases) with medium-level LLV (MLLV), and 4.14% (76 cases) with high-level LLV (HLLV). There was a statistically significant difference in the incidence of VF for LLVs at different levels (P<0.05). The influencing factors of LLV included the current treatment area (Jin'an District OR=3.017, Yeji District OR=3.075, Shucheng County OR=3.473), route of infection (homosexual transmission OR=0.382, heterosexual transmission OR=0.504), change in treatment scheme (OR=1.854), baseline CD4+T lymphocyte count<200/μL (OR=1.642), as well as treatment duration being 1-5 years (OR=0.660). Conclusions There is a high risk for LLV in HIV/AIDS patients in Lu'an City, which increases their risk for VF. The risk factors identified include baseline CD4+T lymphocyte count<200/μL, changing treatment schemes, among others. It is necessary to start ART as earlier as possible and improve the quality of treatment management of patients.

Key words: HIV/AIDS patients, Low-level viraemia, Virus inhibition failure, Influencing factor

中图分类号:

R183.7

陈海燕, 马功燕, 陈栋. 六安市抗病毒治疗HIV/AIDS患者低病毒血症发生情况及影响因素分析[J]. 华南预防医学, 2024, 50(12): 1109-1114.

CHEN Haiyan, MA Gongyan, CHEN Dong. Incidence and influencing factors of low-level viraemia in HIV/AIDS patients treated with antiretroviral therapy in Lu'an City[J]. South China Journal of Preventive Medicine, 2024, 50(12): 1109-1114.

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