摘要
目的了解男男同性性行为人群(men who have sex with men,MSM)中人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者(MSM-HIV)接受含依非韦伦的抗反转录病毒治疗(antiretroviral therapy,ART)持续>6个月的治疗效果及影响因素。方法2021年11月17—24日,在全国31个地区(包括22个省、4个直辖市和5个自治区)通过调查问卷的方式收集患者信息。采用滚雪球抽样方法,线上通过网站社区工作人员宣传,并在微信朋友圈中招募参与者,线下工作人员访问同性恋群体聚集场所招募参与者,采用自编问卷进行调查。采用多因素logistic回归模型分析MSM-HIV ART效果的影响因素。结果本研究共纳入1311例患者,年龄(29.51±8.38)岁,ART失败297例(22.65%)。多因素logistic回归分析显示,年龄40~<50岁(OR=1.62,95%CI:1.09~2.40)、基线病毒载量>200拷贝/ml(OR=1.52,95%CI:1.12~2.07)、ART持续时间>24个月(OR=0.49,95%CI:0.32~0.75)是MSM-HIV感染者采用含依非韦伦的ART效果的影响因素。结论应更多关注高龄、基线病毒载量水平较高的MSM-HIV群体,针对其接受含依非韦伦的治疗方案的病毒学治疗失败状况,加强健康教育,提供经济援助与医疗保障,优化治疗方案,使用抗病毒治疗效果更佳且不良反应更少的药物。
Objective To investigate the efficacy and influencing factors of antiretroviral therapy(ART)contain-ing efavirenz in HIV-infected men who have sex with men(MSM)in China who have undergone treatment for over six months.Methods From November 17 to 24,2021,patient information was collected through ques-tionnaires across 31 regions in China(including 22 provinces,four municipalities,and five autonomous regions).A snowball sampling method was employed,where online recruitment was facilitated by community staff through websites and WeChat,while offline recruitment occurred at venues frequented by the gay community,utilizing a self-developed questionnaire.Logistic regression was employed to analyze the factors influencing the efficacy of ART in MSM.Results A total of 131l patients were included,with a mean age of(29.51±8.38)years.Viro-logical treatment failure was observed in 297 cases(22.65%).Multivariate logistic regression analysis showed that age between 40 and<50 years(OR=1.62,95%CI:1.09-2.40),baseline viral load>200 copies/ml(OR=1.52,95%CI:1.12-2.07),and ART duration>24 months(OR=0.49,95%CI:0.32-0.75)were significant factors affecting the treatment outcomes of MSM-HIV patients receiving efavirenz-based ARTi.Conclusions More attention should be given to older MSM-HIV populations with higher baseline viral loads.Enhanced health education,economic support,and medical assurance should be provided to improve the treatment outcomes of those receiving efavirenz-containing regimens,alongside optimizing treatment plans to utilize more effective antiviral medications with fewer adverse effects.
作者
赵一成
杨杰
于茂河
刘凤利
刘媛媛
崔壮
李长平
ZHAO Yicheng;YANG Jie;YU Maohe;LIU Fengli;LIU Yuanyuan;CUI Zhuang;LI Changping(Department of Epidemiology and Biostatistics,School of Public Health,Tianjin Medical University,Tianjin300070,China;不详)
出处
《中国预防医学杂志》
2025年第6期661-665,共5页
Chinese Preventive Medicine
基金
国家自然科学基金资助项目(72374153)
天津市卫生健康科技项目(ZC20022)
教育部人文社会科学研究一般项目(20YJAZH021)。
作者简介
赵一成,硕士研究生在读,主要从事流行病与卫生统计学研究;通信作者:李长平,E-mail:lichangping@tmu.edu.cn。
