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    2006—2021年贵港市HIV/AIDS患者抗病毒治疗免疫学失败及影响因素分析

    Immunological failure of antiretroviral therapy of HIV/AIDS patients in Guigang city from 2006 to 2021 and its influencing factors

      摘要
    • 摘要: 目的：分析2006—2021年贵港市HIV/AIDS患者抗病毒治疗（ART）免疫学失败情况及其影响因素。方法：从“国家免费艾滋病防治信息系统”收集2006—2021 年在贵港市接受ART 的HIV/AIDS 患者数据，通过寿命表法描述总体免疫学失败情况，用多因素COX 回归模型分析免疫学失败的影响因素。结果：本研究共纳入HIV/AIDS 患者6 903例，其中4 314 例（61.28%）出现ART免疫学失败。第1、第5、第10年免疫学失败累积发生率分别为57.9%、67.3%、68.6%。基线CD4+T细胞计数在200～350 个/μL 和＞ 350 个/μL（以＜200 个/μL 为参照，HR=1.098，95%CI=1.011～1.192，P=0.027；HR=1.112, 95%CI=1.001～1.236, P=0.048）、基线WHO临床分期Ⅲ期（以Ⅰ期为参照，HR=1.156, 95%CI=1.058～1.263, P=0.001）、使用AZT+3TC+NVP治疗方案（以TDF+3TC+EFV 为参照，HR=1.538，95%CI=1.394～1.696，P＜0.001）等患者的免疫学失败风险更高。结论：贵港市HIV/AIDS患者ART免疫学失败率较高，影响因素较复杂，应对不同特征患者采取针对性临床管理措施，通过加强CD4+T细胞水平的监测，及时调整治疗方案等，提高贵港市HIV/AIDS患者ART效果。

       

      Abstract: Objective: To analyze the immunological failure of antiretroviral therapy (ART) of HIV/AIDS patients in Guigang city from 2006 to 2021 and its influencing factors.Methods: The data of HIV/AIDS patients who received ART in Guigang city from 2006 to 2021 were collected from the National Free AIDS Prevention and Control Information System.The life table method was used to describe the overall immunological failure of the subjects.Multivariate COX regression model was used to analyze the influencing factors of immunological failure.Results: A total of 6, 903 HIV/AIDS patients were included in this study, of whom 4, 314 (61.28%) suffered ART immunological failure.The cumulative incidence of immunological failure was 57.9%、67.3% and 68.6% in the 1st, 5th and 10th year, respectively.Patients infected with HIV, with the baseline CD4+T cell count 200-350 cells/μL and ＞ 350 cells/μL (referenced to ＜ 200 cells/μL, HR=1.098, 95% CI=1.011-1.192, P=0.027 and HR=1.112, 95% CI=1.001-1.236, P=0.048), baseline WHO clinical stage at Ⅲ (referenced to stage Ⅰ, HR=1.156, 95%CI=1.058-1.263, P=0.001), and using AZT+3TC+NVP regimen (referenced to TDF+3TC+EFV, HR=1.538, 95% CI=1.394-1.696, P＜ 0.001) had a higher risk of immunological failure.Conclusion: The immunological failure rate of ART patients in Guigang city is relatively high, and the influencing factors are complex.Targeted clinical management measures should be taken for the patients with different characteristics.The ART effect of HIV/AIDS patients in Guigang city can be improved by strengthening the monitoring of CD4+T cell level and timely adjusting the ART regimens, etc.

       

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