摘要
目的掌握2014-2018年南京市新报告艾滋病病毒(HIV)感染者/艾滋病(AIDS)病例(简称HIV/AIDS病例)特征和首次CD4+T淋巴细胞(简称CD4细胞)检测情况,并分析及时检测CD4细胞的相关因素。方法每年1月自《艾滋病综合防治信息系统》下载前一年的病例报告历史卡片数据库。运用卡方趋势检验、单因素方差分析和二分类Logistic回归方程法统计分析。结果南京市2014-2018新报告HIV/AIDS病例3 988例,纳入分析3 979例。以男性(91.9%)、汉族(96.3%)、25~49岁组(57.7%)、未婚(54.8%)、现住址为本地人口(70.7%)和文化程度大专及以上(46.9%)为主。≥50岁、流动人口和性病门诊来源病例分别从13.6%上升至23.0%,23.6%上升至37.5%,8.4%上升至11.4%。HIV/AIDS病例首次CD4细胞检测率从87.2%上升至92.4%,及时检测率从48.5%上升至67.4%,但是CD4细胞计数均值下降至336.8个/μL,计数高于350个/μL比例下降至44.0%。多因素Logistic回归方程分析显示,年龄越低(15~24岁)、流动人口、文化程度初中及以下和体检类发现的HIV/AIDS病例及时检测率较低,分别为47.9%、39.8%、48.8%和41.0%。结论本次分析的病例50岁及以上老年人和流动人口逐年上升,首次CD4细胞检测率和及时检测率均显著提升,但诊断延迟情况严峻。应重点加强病例早发现能力,在提高CD4细胞及时检测方面,应更关注年轻人、流动人口、学历低和体检发现的病例。
Objective To know the epidemiological characteristics and first CD4^+ T lymphocyte cell test of newly reported HIV/AIDS cases from 2014 to 2018 in Nanjing city, and the factors related to timely test of CD4^+ T cell. Methods Data were downloaded from the National Comprehensive AIDS Case Report System every January. Frequency distribution, linear-by-linear χ~2 test, one way ANOVA test, and binary logistic regression model were used for the analysis. Results 3 988 HIV/AIDS cases were newly reported in Nanjing from 2014 to 2018 and 3 979 were analyzed. Most of them were male, Han ethnic, aged between 25-49 years, single, local residents and college educated and above. Cases aged ≥ 50, migrant population and cases reported from STD clinics rose from 13.6% to 23.0%, 23.6% to 37.5%, and 8.4% to 11.4% respectively. The rate of CD4^+ T lymphocyte cell test and that of timely test in the newly reported cases increased from 87.2% to 92.4% and 48.5% to 67.4%. However, the mean CD4^+ T lymphocyte cell count decreased from 383.1/μL to 336.8/μL, and the proportion of higher than 350/μL CD4^+ T lymphocyte cell count decreased from 56.0% to 44.0%. Binary logistic regression analysis indicated that the factors related to lower proportion of timely CD4^+ T lymphocyte cell test among the cases included those being young(15-24 age)(47.9%), migrant(39.8%), lower-level educated(48.8%) and diagnosed as HIV infection due to medical examination(41.0%). Conclusion Elderly and migrant population are increasing among newly reported HIV/AIDS cases from 2014 to 2018 in Nanjing city. CD4^+ T lymphocyte cell test and timely test proportions increase. However, the late diagnosis of HIV infection is serious. We should focus on early diagnosis in the future, and to promote timely CD4^+ T cell test, esp. for the cases of young people, migrants, lower educated and reported due to medical examination.
作者
朱正平
吴苏姝
刘黎
郭璐
徐园园
李昕
ZHU Zhengping;WU Sushu;LIU Li;GUO Lu;XU Yuanyuan;LI Xin(Section of AIDS Control and Prevention,Nanjing Municipal Center for Disease Control and Prevention,Nanjing 210003,China)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2020年第1期8-12,共5页
Chinese Journal of Aids & STD
基金
南京市医学重点专科(传染病预防控制科)
南京市医学科技发展一般性课题(YKK18176)~~.
作者简介
第一作者:朱正平(1980-),女,安徽省桐城市人,副主任医师,硕士研究生,主要研究艾滋病性病防治。Email:zzp@njcdc.cn
