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目的了解中国成人艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)抗病毒治疗失访比例及其影响因素。方法对全国免费抗病毒治疗库中,2012年1月1日至12月31日开始抗病毒治疗的HIV/AIDS病人失访情况进行随访,随访截止到2014年12月31日。采用Cox比例风险模型分析队列失访率及其影响因素。结果共有26 742名HIV感染者进入队列。12个月的累积失访率为7.6/100人年,24个月的累积失访率为10.5/100人年。Cox比例风险模型多因素分析显示,基线高CD4+T淋巴细胞组、注射吸毒、异性性传播以及初始治疗方案为齐多夫定/司坦夫定+拉米夫定+依非韦伦/奈韦拉平与较高的失访率相关(P<0.05)。结论应该重点强化注射吸毒HIV/AIDS病人的干预措施,加强对高基线CD4+T淋巴细胞HIV/AIDS病人感染者的医疗咨询,对治疗药物有不良反应的病人要及时处理或更换治疗方案。
Objective To understand the proportion of loss-of-treatment and its influencing factors of antiviral therapy for adults with HIV / AIDS in China (referred to as HIV / AIDS patients). Methods Follow-up of HIV / AIDS patients who started anti-virus treatment in the national free anti-virus treatment library from January 1 to December 31, 2012 was followed up until December 31, 2014. Cox proportional hazards model was used to analyze the cohort loss rate and its influencing factors. A total of 26 742 HIV-infected patients were enrolled in the cohort. The cumulative lost rate at 12 months was 7.6 / 100 person-years and the cumulative 24-month lost rate was 10.5 / 100 person-years. Cox proportional hazards model multivariate analysis showed that baseline high CD4 + T lymphocyte group, injection drug abuse, heterosexual transmission and the initial treatment programs for zidovudine / stavudine + lamivudine + efavirenz / nevirapine With a higher rate of loss of follow-up (P <0.05). Conclusions Interventions should be focused on HIV / AIDS patients injecting drug abuse to strengthen medical consultation on HIV / AIDS patients with high baseline CD4 + T lymphocytes. Patients who have adverse reactions to treatment drugs should be treated or replaced promptly.