摘要
目的分析历年来广东省≥50岁HIV/AIDS患者入组艾滋病免费ART影响因素及不同首次CD4细胞计数入组人数变化趋势。方法利用广东省艾滋病病例报告卡历史卡片库、随访管理数据库和抗病毒治疗管理数据库,分析广东省≥50岁HIV/AIDS患者接受抗病毒治疗的影响因素,用Joinpoint 4.7.0.0进行≥50岁HIV/AIDS患者入组治疗人数变化趋势特征分析。结果纳入1998-2019年共计20 425例患者,其中入组治疗患者11 869例(58.1%)。广东省≥50岁患者性别为女性、职业为非农民(除干部职员外)、户籍地为外省、文化程度高、婚姻状况为已婚有配偶、离异或丧偶、感染途径为同性性传播和异性性传播、样本来源为检测咨询和阳性者配偶或性伴检测、2016年及以后确诊的患者接受ART的概率更高(P均<0.05);年龄越大、首次CD4细胞水平高(≥200个/μL)、样本来源为监管场所体检的患者接受ART的概率更低(P均<0.05)。首次CD4细胞计数<200个/μL组、200~349个/μL组、350~499个/μL组入组治疗人数变化趋势随着报告病例数增加和治疗政策逐步放开而呈上升趋势,近期上升速度趋缓;≥500个/μL组则呈先上升再下降的趋势。结论广东省存活≥50岁HIV/AIDS患者接受免费ART比例仍需要进一步提高,治疗政策变化是推动高年龄患者的因素之一,需针对不同特征人群采取有效措施,加大治疗宣教力度及规范管理,进一步提高入组治疗比例。
Objective To analyze the influencing factors of free ART and the changing trend of the baseline CD4 cell count among HIV/AIDS patients aged 50 years or older in Guangdong. Methods We collected data from the history card database, follow-up management database, and antiviral treatment management database of AIDS case report card in Guangdong Province. We analyzed the influencing factors of antiviral treatment for HIV/AIDS and the changing trend of the number of patients in group HIV/AIDS aged 50 or above in Guangdong by Joinpoint 4.7.0.0. Results A total of20425 patients were included from 1998 to 2019, including 11869 patients(58.1%) received ART treatment. In Guangdong Province, there were several factors associated with high probability to receive the ART treatment including being a female, aged 50 years and above, being a non-farmer(except cadres), registered residence being outside Guangdong, with a high education level, being married, divorced or widowed, the transmission route being homosexual and heterosexual sex, being referred by volunteer testing and consultation sites or couple testing, and being diagnosed in2016 or beyond.(all P < 0.05). Older age, with a higher level of baseline CD4 cells(≥ 200 cells)/μL), being referred by regular physical examination were associated with lower probability of receiving ART(all P < 0.05). The number of participants enrolled in groups with the baseline of CD4 cell count was < 200/μ L, 200-349/μL, 350-499/μL showed an upward trend with the increase of the number of cases reported and the gradual liberalization of treatment policies.Recently, the rate of increasing went slow. The number of patients enrolled among groups in ≥ 500/μL had shown an increased trend and then a decreased trend afterwards. Conclusion The proportion of HIV/AIDS patients aged≥ 50 years who received the free ART needs to be further improved in Guangdong. The change of treatment policy is one of the factors to promote elderly patients to be treated. Effective measures should be taken for
作者
谢仕兰
付笑冰
刘珺
刘优招
黎健荣
潘丝媛
杨放
XIE Shilan;FU Xiaobing;LIU Jun;LIU Youzhao;LI Jianrong;PAN Siyuan;YANG Fang(Guangdong Provincial Center for Disease Control and Prevention,Guangzhou 511430,China)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2021年第12期1409-1413,共5页
Chinese Journal of Aids & STD
基金
广东省医学科学技术研究基金项目(C2019054)。
关键词
50岁
艾滋病
抗病毒治疗
趋势
影响因素
50 years and over
acquired immunodeficiency syndrome
free antiretroviral therapy
trend
influencing factors
