2015—2021年南昌市HIV/AIDS抗病毒治疗病毒学失败率及其影响因素分析

doi:10.3969/j.issn.1006-3110.2023.06.002

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摘要目的分析南昌市2015—2021年抗病毒治疗持续时长超过6个月的HIV/AIDS病毒学失败率及其影响因素,为综合评价和及时干预提供参考。方法采用回顾性分析方法,收集2015—2021年国家艾滋病综合防治信息系统、中国疾病预防控制信息系统以及南昌市定点医院的HAART相关数据资料,分析患者HAART病毒学失败的影响因素。结果共纳入研究对象1 690例HIV/AIDS,病毒学失败率5.76/100人年。多因素logistic分析结果显示,注射吸毒/输血传播(aOR=9.66,95%CI:2.00~46.61)、HAART持续时长不足1年(aOR=2.49,95%CI:1.01~6.09)、最近CD4⁺T淋巴细胞计数＜200个/μl(aOR=12.59,95%CI:6.45~24.62)和最近CD4⁺T淋巴细胞计数介于200~500个/μl(aOR=2.52,95%CI:1.32~4.79)、初始HAART方案“AZT+3TC+EFV/NVP”(aOR=2.54,95%CI:1.27~5.06)、最近7 d漏服抗病毒药物(aOR=7.99,95%CI:3.88~16.45)、丙型肝炎合并感染(aOR=4.86,95%CI:1.81~13.03)、耐药检测阳性(aOR=4.09,95%CI:1.85~9.04)是HIV/AIDS抗病毒治疗病毒学失败的影响因素。结论在目前抗病毒治疗策略下,需着重关注HIV/AIDS的传播方式、治疗时长、自身免疫水平、漏服抗病毒药物、丙型肝炎合并感染、耐药等情况,综合评价并及时干预,以减少因病毒学失败识别滞后而出现不良结局。

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	涂志斌
	路亮
	邱丽萍
	付玲
	罗生根
	应艳
	陈小龙

关键词 ： HIV/AIDS, 病毒学失败, 影响因素

Abstract：Objective To analyze the rate and influencing factors of virologic failure of antiretroviral therapy (HAART) lasting more than 6 months for HIV/AIDS in Nanchang City during 2015-2021, and to provide references for comprehensive assessment and timely intervention. Methods A retrospective analysis method was used to collect the data related to HAART from the National Information System for HIV/AIDS Comprehensive Prevention and Control, China Information System for Disease Control and Prevention and designated hospitals in Nanchang City, and the factors influencing virologic failure in patients with HAART were analyzed. Results A total of 1,690 patients with HIV/AIDS were enrolled in the study, with a virologic failure rate of 5.76/100 person-years. The results of multivariate logistic regression analysis indicated that injecting drug use/transmission by blood transfusion (aOR=9.66, 95%CI:2.00-46.61), HAART lasting time < 1 year (aOR=2.49, 95%CI:1.01-6.09), recent CD4+T-lymphocyte cell counts < 200 cells/μl (aOR=12.59, 95%CI:6.45-24.62) and recent CD4⁺T-lymphocyte cell counts ranged 200-500 cells/μl (aOR=2.52, 95%CI:1.32-4.79), the initial HAART regimen “AZT+3TC+EFV/NVP” (aOR=2.54, 95%CI:1.27-5.06), missed taking antiviral medication in the last 7 days (aOR=7.99, 95%CI:3.88-16.45), HIV/AIDS and hepatitis C virus co-infection (aOR=4.86, 95%CI:1.81-13.03), positive drug resistance test (aOR=4.09, 95%CI:1.85-9.04) were factors affecting virologic failure in the HIV/AIDS patients with HAART. Conclusion Under the current HAART strategy, it is necessary to pay special attention to the mode of transmission for HIV/AIDS, lasting time of HAART, self-immune level, missed taking antiviral medication, HIV/AIDS and hepatitis C virus co-infection and drug resistance, and conduct comprehensive evaluation and timely intervention so as to reduce adverse outcomes due to late identification of virologic failure.

Key words： human immunodeficiency virus/acquired immunodeficiency syndrome virologic failure influencing factor

收稿日期: 2022-07-25

R512.91

基金资助:江西省卫生健康委科技计划项目 (SKJP220202830);江西省卫生健康委科技计划项目(SKJP220228190)

作者简介: 涂志斌(1984-),男,硕士,主要从事艾滋病防治工作。

引用本文:

涂志斌, 路亮, 邱丽萍, 付玲, 罗生根, 应艳, 陈小龙. 2015—2021年南昌市HIV/AIDS抗病毒治疗病毒学失败率及其影响因素分析[J]. 实用预防医学, 2023, 30(6): 646-650. TU Zhi-bin, LU Liang, QIU Li-ping, FU Ling, LUO Sheng-gen, YING Yan, CHEN Xiao-long. Virologic failure rate of antiretroviral therapy for HIV/AIDS and its influencing factors in Nanchang City, 2015-2021. , 2023, 30(6): 646-650.

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