摘要
目的 了解台州市HIV感染者中糖尿病、心血管病和恶性肿瘤等慢性病合并症患病特征.方法 资料来源于中国疾病预防控制信息系统和台州市慢性病信息管理系统,研究对象为台州市1998-2022年随访管理的5 126例HIV感染者,采用SAS 9.4软件进行x2检验、趋势分析和logistic回归分析.结果 在5 126例HIV感染者中,糖尿病、心血管病和恶性肿瘤的报告患病率分别为10.28％(527/5 126)、3.98％(204/5 126)和6.01％(308/5 126),在HIV感染确证前与确证后被诊断为糖尿病、心血管病和恶性肿瘤的分别占 37.00％(195/527)与 48.58％(256/527)、40.20％(82/204)与 48.53％(99/204)、37.66％(116/308)与48.38％(149/308).2013-2022年HIV感染者在确证后分别被诊断为糖尿病、心血管病和恶性肿瘤的构成比均呈上升趋势(趋势x2=79.98,P＜0.001;趋势x2=17.44,P＜0.001;趋势x2=32.06,P＜0.001).HIV感染者慢性病合并症的患病相关因素分析结果显示,＜60岁女性(aOR=0.66,95％CI:0.50～0.86)、2016年以前抗病毒治疗时长＞5年者(aOR=0.54,95％CI:0.37～0.78)的慢性病合并症的患病可能性较低;＜60岁且首次CD4+T淋巴细胞计数＜200个/µl者(aOR=1.32,95％CI:1.02～1.70)、40～49 和 50～59 岁年龄组(aOR=2.88,95％C/:2.20～3.79;aOR=5.43,95％C/:4.10～7.21)、2016 年及以后无用药记录者(aOR=1.95,95％CI:1.20～3.16)的慢性病患病可能性较高.随着HIV感染者确证年龄增长,其慢性病合并症的患病可能性随之增加.结论 1998-2022年台州市HIV感染者存在一定比例的慢性病合并症,且在HIV感染确证后诊断的构成比呈上升趋势,需要在HIV感染者管理中加强早期慢性病筛查、行为干预和规范管理等针对性措施.
Abstract
Objective To understand the prevalence of major chronic diseases of diabetes,cardiovascular disease and malignant tumor in people living with HIV in Taizhou.Methods The data were collected from China Information System for Disease Control and Prevention and Taizhou Chronic Disease Information Management System.A total of 5 126 people living HIV under follow-up in Taizhou from 1998 to 2022 were included in the analysis.Software SAS 9.4 was used for x2 test,trend analysis and logistic regression analysis.Results In the 5 126 people living with HIV,the reported prevalence rates of diabetes,cardiovascular disease and malignant tumor were 10.28％(527/5 126),3.98％(204/5 126)and 6.01％(308/5 126),respectively.37.00％(195/527)and 48.58％(256/527),40.20％(82/204)and 48.53％(99/204),37.66％(116/308)and 48.38％(149/308)were diagnosed as diabetes,cardiovascular disease and malignant tumor before and after confirmation of HIV infection.From 2013 to 2022,the proportion of HIV infected people diagnosed with diabetes,cardiovascular disease and malignant tumor after confirmation increased(trend x2=79.98,P＜0.001;trend x2=17.44,P＜0.001;trend x2=32.06,P＜0.001).Based on the analysis on the factors for complicated chronic diseases in people living with HIV,it was found that women under 60 years old(aOR=0.66,95％CI:0.50-0.86)and those with access to antiviral treatment for＞5 years before 2016(aOR=0.54,95％CI:0.37-0.78)were less likely to develop complicated chronic diseases,and those under 60 years old with initial CD4+T lymphocytes counts＜200 cells/μl(aOR=1.32,95％CI:1.02-1.70),those aged 40-49 and 50-59 years(aOR=2.88,95％CI:2.20-3.79;aOR=5.43,95％CI:4.10-7.21)as well as those without a record of treatment medication use after 2016(aOR=1.95,95％CI:1.20-3.16)were more likely to develop complicated chronic diseases.The probability of developing complicated chronic diseases might increase with age in people living with HIV.Conclusions From 1998 to 2022,there was a certain proportion of complicated chronic diseases among HIV infected individuals in Taizhou,and the proportion of diagnosed cases increased after HIV infection was confirmed.It is necessary to conduct early chronic disease screening,behavior intervention and standardized management in people living with HIV.
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