Analysis of attrition among HIV-infected/AIDS patients receiving initial antiretroviral treatment and its influencing factors in Guiyang City
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目的 了解贵州省贵阳市人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者和获得性免疫缺陷综合征(acquired immunodeficiency syndrome,AIDS)患者初始抗反转录病毒治疗(antiretro-viral therapy,ART)脱失的情况及影响因素,为进一步制定降低脱失率的防治政策提供依据.方法 采用回顾性队列研究方法对贵阳市2005年1月1日-2021年12月31日入组的ART患者的基线数据进行统计分析,采用Cox比例风险回归模型探讨不同人口学特征、不同基线状况ART患者的脱失风险,并收集脱失患者ART脱失的原因.结果 贵阳市ART患者治疗随访期间脱失1 037例(9.26％),总脱失率2.55/100人年.男性(HR=1.54,95％CI:1.32～1.81,P＜0.01)、年龄≥50岁(HR=1.27,95％CI:1.01～1.58,P=0.035)、未婚(HR=1.44,95％CI:1.19～1.75,P＜0.01)、离异或丧偶(HR=1.67,95％CI:1.42～1.96,P＜0.01)、高中及以下文化程度(HR=1.63,95％CI:1.34～1.99,P＜0.01)、农民(HR=1.32,95％CI:1.02～1.71,P=0.034)、静脉吸毒(HR=2.15,95％CI:1.71～2.69,P＜0.01)、基线 CD4+T 淋巴细胞计数在 350～＜500 个/μl(HR=3.30,95％CI:2.39～4.55,P＜0.01)、初始 ART 方案含齐多夫定(HR=1.29,95％CI:1.08～1.54,P=0.006)、ART 前乙肝感染(HR=1.55,95％CI:1.25～1.92,P＜0.01)、ART前结核感染(HR=1.61,95％CI:1.18～2.22,P=0.003)、开始 ART 时间为 2016-2021 年(HR=1.63,95％CI:1.15～2.31,P=0.006)是 ART 脱失的危险因素.结论 对脱失风险较高的人群应当采取有针对性的防控措施,提高随访工作质量,以减少脱失的发生.
Objective To understand the stutas of attrition receiving antiretroviral treatment(ART)and its influencing factors among HIV-infected/AIDS patients in Guiyang City,Guizhou Province,and provide evidence for developing policies to reduce the attrition rate.Methods A retrospective cohort study was conducted to analyze the baseline data of ART patients enrolled in Guiyang City from January 1,2005,to December 31,2021.The Cox proportional hazard regression model was used to explore the risk of attrition among ART patients with different demographic characteristics and baseline conditions,and the reasons for attrition were collected.Results During the follow-up period of ART patients in Guiyang City,1 037 cases(9.26％)were lost to follow-up with a loss rate of 2.55/100 person-years.Male(HR=1.54,95％CI:1.32-1.81,P＜0.01),age≥50 years old(HR=1.27,95％CI:1.01-1.58,P=0.035),unmarried(HR=1.44,95％CI:1.19-1.75,P＜0.01),divorced or widowed(HR=1.67,95％CI:1.42-1.96,P＜0.01),highschool education or below(HR=1.63,95％CI:1.34-1.99,P＜0.01),farmers(HR=1.32,95％CI:1.02-1.71,P=0.034),intravenous drug users(HR=2.15,95％CI:1.71-2.69,P＜0.01),baseline CD4+T lymphocyte count between 350-＜500 cells/μl(HR=3.30,95％CI:2.39-4.55,P＜0.01),initial ART regimen containing zidovudine(HR=1.29,95％CI:1.08-1.54,P=0.006),hepatitis B virus infection before ART(HR=1.55,95％CI:1.25-1.92,P＜0.01),tuberculosis infection before ART(HR=1.61,95％CI:1.18-2.22,P=0.003),and ART initiation time from 2016 to 2021(HR=1.63,95％CI:1.15-2.31,P=0.006)were risk factors of attrition receiving antiviral treatment.Conclusions Targeted prevention and control measures should be taken for people with a high risk of attrition to reduce its occurrence and improve the quality of follow-up work.
Human immodeficiency virusAcquired immunodeficiency syndromeAntiretroviral therapyAttrition
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