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目的了解四川省布拖县重点地区艾滋病病毒(HIV)感染儿童抗病毒治疗情况,为提高治疗效果提供建议。方法 2015年1~3月,对现住址为布拖县重点乡镇感染艾滋病儿童的监护人进行一对一的问卷调查,内容包括儿童一般人口学特征,监护人对抗病毒治疗的认知,以及儿童抗病毒治疗现状等,并从《艾滋病综合防治信息系统》收集CD4~+T细胞计数与病毒载量检测等相关信息。用SPSS 19.0软件进行频率描述,配对t检验和秩和检验等统计分析,P<0.05为差异有统计学意义。结果接受调查的121名儿童中有68人(56.20%)正在接受抗病毒治疗,开始治疗时平均年龄(8.12±2.32)岁,平均已治疗(1.92±1.09)年。在治儿童第一次CD4~+T细胞计数水平显著高于基线(P=0.034);两次病毒载量检测结果差异无统计学意义(P=0.533)。有56人(46.28%)不知道需要每天坚持服药;19人(15.70%)不知道何时应开始治疗。结论布拖县感染艾滋病儿童疾病负担重,其监护人对抗病毒治疗认知存在不足;儿童抗病毒治疗覆盖率不高,虽然早期CD4~+T细胞计数明显升高,但中长期效果尚不显著;提示应加强儿童治疗医务人员技术培训,开展家庭内长期支持儿童抗病毒治疗宣传,以提高儿童长期抗病毒治疗效果。
Objective To understand the antiviral treatment of children with HIV infection in key areas of Budu County in Sichuan Province and to provide suggestions for improving the therapeutic effect. Methods From January to March 2015, a one-on-one questionnaire survey was conducted on guardians of AIDS-infected children in key villages and towns in the county of Bhuo, covering general demographic characteristics of children, guardian’s cognition of anti-virus treatment, and children’s antiviral Treatment status, etc., and from the “AIDS Prevention and Control Information System” to collect CD4 ~ + T cell count and detection of viral load and other related information. SPSS 19.0 software for frequency description, paired t test and rank sum test and other statistical analysis, P <0.05 for the difference was statistically significant. Results Of the 121 children surveyed, 56 (56.20%) were receiving antiviral therapy and the mean age at onset of treatment was 8.12 ± 2.32 years (mean, 1.92 ± 1.09 years). The first CD4 ~ + T cell count in children undergoing treatment was significantly higher than that at baseline (P = 0.034); there was no significant difference between the two viral load testings (P = 0.533). 56 (46.28%) did not know that they needed to take their medicine daily; 19 (15.70%) did not know when to start treatment. Conclusion The children with AIDS in Buwa County have a heavy burden of disease and their guardians have insufficient knowledge of antiretroviral treatment. The coverage of antiretroviral therapy in children is not high. Although the number of early CD4 ~ + T cells is significantly increased, the medium and long term effects are not significant. It is suggested that the technical training of medical staff for treatment of children should be strengthened and the long-term advocacy of antiretroviral therapy for children in the family should be promoted so as to enhance the long-term anti-viral treatment effect in children.