金华市AIDS病人抗病毒治疗病毒学失败情况分析

发布时间：2018-07-13 10:01

【摘要】：目的了解金华市艾滋病(AIDS)病人接受抗病毒治疗后病毒学抑制效果,分析病毒学失败的发生状况及其影响因素。方法通过国家艾滋病综合防治信息系统收集资料,并进行描述性和分析性流行病学分析。结果 1 009例治疗病例有70例病毒学失败,病毒学失败率6.94%;多因素Logistic回归分析结果显示,低年龄、近期CD4+T淋巴细胞(简称CD4细胞)水平低、最近7天有漏服药物、最近治疗方案为拉米夫定(3TC)+齐多夫定(AZT)+奈韦拉平(NVP)是出现病毒学失败的影响因素。年龄20岁以下组病毒学失败可能性高于年龄20至39岁组[比值比(OR)=0.088,95%可信区间(CI):0.018~0.421];近期CD4细胞水平200个/μL以下病毒学失败可能性高于200至399个/μL(OR=0.051,95%CI:0.019~0.135)和400个/μL及以上(OR=0.189,95%CI:0.072~0.497);最近7天有漏服药物病毒学失败可能性高于未漏服(OR=0.061,95%CI:0.009~0.389);最近治疗方案为3TC+AZT+NVP出现病毒学失败的可能性高于3TC+AZT+依非韦仑(EFV)(OR=4.276,95%CI:1.558~11.733)。结论金华市AIDS病人抗病毒治疗失败率处于较低水平,针对重点人群进行强化抗病毒治疗依从性指导,加强CD4细胞水平监测,优化治疗方案等措施有助于减低病毒学失败率。
[Abstract]:Objective to investigate the virological inhibition effect of AIDS patients in Jinhua city and analyze the occurrence of virology failure and its influencing factors. Methods the data were collected through the National AIDS Integrated Prevention and Control Information system, and the descriptive and analytical epidemiological analysis were carried out. Results among 1 009 cases, 70 cases failed in virology, and the failure rate of virology was 6.94. The results of multivariate logistic regression analysis showed that the level of CD4 T lymphocytes (CD4 cells) was low in the near future, and the drug was given out in the last 7 days. The most recent treatment was lamivudine (3TC) zidovudine (AZT) nevirapine (NVP) which was associated with virological failure. The probability of virology failure in the group under 20 years of age is higher than that in the group aged 20 to 39 years [odds ratio (OR) 0.088 95% confidence interval (CI): 0.018 ~ 0.421]; the failure probability of virology in the recent period below 200 / 渭 L of CD4 cell level is higher than that of 200 to 399 / 渭 L (ORA 0.05195 CIW 0.0190.135) and 400 / 渭 L / 渭 L and above (ORT 0.189 95 CI: 0.0720.97); In the last 7 days, the failure probability of drug virology with drug leakage was higher than that without (OR 0.061% 95% CI: 0.009 / 0.389), and the recent treatment regimen 3TC AZT NVP was more likely to fail in virology than that in 3TC AZT EVV (OR4.27695 CI: 1.55811.733). Conclusion the failure rate of AIDS patients in Jinhua City is at a low level. It is helpful to reduce the failure rate of virology by strengthening the compliance guidance of anti-viral therapy, strengthening the monitoring of CD4 cell level and optimizing the treatment plan.
【作者单位】：金华市疾病预防控制中心;
【分类号】：R512.91

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