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目的了解重庆市艾滋病抗病毒治疗者的病毒载量(VL)抑制情况,分析其影响因素,为细化抗病毒治疗措施提供建议。方法采用回顾性研究方法,评估抗病毒治疗的病毒学效果。在国家艾滋病综合防治信息系统中下载抗病毒治疗病例的历史卡片,对数据库进行信息筛选和关联。数据核查后运用SPSS 18.0软件进行统计分析。结果 9 302例治疗患者平均年龄(44.6±14.7)岁,男性占75.3%,女性占24.7%。患者基线CD4~+T淋巴细胞(简称CD4细胞)平均值(中位数)为231个/μL,治疗后CD4细胞值平均为362个/μL。患者病毒载量检测结果<400拷贝/mL的占89.5%,≥400拷贝/mL的占10.5%。多因素Logistic回归分析显示,同性性接触[比值比(OR)=1.60]、长期坚持治疗≥25个月(OR=1.46)、较高基线CD4细胞值、实施中默项目措施(OR=1.32),是患者治疗后VL有效抑制的保护性因素;静脉吸毒传播(OR=0.41)、治疗时间≤3月(OR=0.19)、最近7天漏服药物≥4次(OR=0.16)、最近出现过药品不良反应(OR=0.40),是患者治疗VL有效抑制的危险性因素。结论继续推行扩大治疗策略,针对影响治疗效果的影响因素细化工作措施,进一步提高治疗质量。
Objective To understand the inhibition of viral load (VL) in HIV-infected patients in Chongqing and to analyze its influencing factors, so as to provide suggestions for the detailed anti-viral treatment. Methods A retrospective study was conducted to evaluate the virologic effect of antiviral therapy. In the national AIDS prevention and control information system to download the history of anti-virus treatment of medical cards, the database for information screening and correlation. After data verification, SPSS 18.0 software was used for statistical analysis. Results The average age of 9 302 patients (44.6 ± 14.7 years) was 75.3% for males and 24.7% for females. The mean (median) CD4 + T lymphocyte (CD4) count of patients at baseline was 231 cells / μL, with an average CD4 cell count of 362 cells / μL after treatment. Patients with viral load test results <400 copies / mL accounted for 89.5%, ≥ 400 copies / mL accounted for 10.5%. Multivariate Logistic regression analysis showed that homosexual exposure [odds ratio (OR) = 1.60], long-term adherence to treatment ≥25 months (OR = 1.46), higher baseline CD4 cell count, (OR = 0.41), treatment time ≤ 3 months (OR = 0.19), missed medication more than 4 times in the last 7 days (OR = 0.16), the recent emergence Adverse drug reaction (OR = 0.40) was a risk factor for effective suppression of VL in patients. Conclusions Continue to expand the treatment strategy, and refine the work measures based on the influencing factors that affect the treatment effect, so as to further improve the quality of treatment.