目的 研究1989-2012年云南省保山市HIV感染者和艾滋病患者的失访率及其影响因素.方法 通过中国疾病预防控制信息系统的子系统“艾滋病综合防治信息系统”收集1989-2012年现住址为保山市的HIV感染者和艾滋病患者的相关信息,包括一般人口学特征(性别、年龄、职业、婚姻状况和文化程度等)、可能感染HIV途径、病程阶段、抗病毒治疗状态、样本来源、首次CD4+T淋巴细胞计数、病例随访状况等.对HIV感染者和艾滋病患者的一般情况和失访情况进行描述,应用Cox比例风险回归模型分析其失访率影响因素.结果 1989-2012年现住址为保山市的HIV感染者和艾滋病患者共3 295例,累计观察11 416.59人年,失访222例,失访率为0.0194/人年,其中2008年的失访率最高,为0.052 8/人年,2012年失访率最低,为0.006 2/人年.失访者中,男性占56.76％(126/222),失访率为0.0204/人年,女性占43.24％(96/222),失访率为0.018 3/人年;户籍为本市、本省其他市、外省、非中国国籍者分别占53.60％(119/222)、28.83％(64/222)、5.86％(13/222)、11.71％(26/222),失访率分别为0.012 5/人年、0.046 3/人年、0.0536/人年、0.095 6/人年;已接受和未接受抗病毒治疗者分别占6.76％(15/222)、93.24％ (207/222),失访率分别为0.001 9/人年、0.058 8/人年;病程为艾滋病和HIV感染阶段者分别占8.11％ (18/222)、91.89％(204/222),失访率分别为0.003 3/人年、0.034 5/人年;首次CD4+T淋巴细胞计数为＜ 200、200～350、＞350个/ml者分别占4.95％(11/222)、73.87％(164/222)、21.17％ (47/222),失访率分别为0.004 8/人年、0.024 0/人年、0.020 3/人年.多因素Cox回归分析结果显示:原籍为本省其他市(HR =3.11,95％ CI:2.28～4.25)、外省(HR =2.55,95％CI:1.42 ～4.56)、非中国国籍者(HR =2.12,95％ CI:I.35 ～3.33)失访的风险均高于原籍为本市者;未接受抗病毒治疗(HR=20.83,95％ CI:11.74 ～36.96)和病程为HIV感染阶段者(HR =3.61,95％CI:1.82 ～7.16)失访的风险分别高于接受抗病毒治疗和艾滋病阶段者,而首次CD4+T淋巴细胞计数为200～ 350(HR=0.35,95％ CI:0.15 ～0.82)和＞350个/ml者(HR =0.29,95％ CI:0.12 ～0.72)失访的风险低于CD4+T淋巴细胞计数＜200个/ml者;可能的感染途径为注射毒品者(HR =0.60,95％CI:0.41～0.88)失访风险低于异性传播者.结论 现住址为保山市HIV感染者和艾滋病患者的失访率总体呈下降趋势,非中国国籍及外地、异性性传播、HIV感染者、首次CD4+T淋巴细胞计数＜200个/ml的病例失访风险较高.
目的 研究1989-2012年雲南省保山市HIV感染者和艾滋病患者的失訪率及其影響因素.方法 通過中國疾病預防控製信息繫統的子繫統“艾滋病綜閤防治信息繫統”收集1989-2012年現住阯為保山市的HIV感染者和艾滋病患者的相關信息,包括一般人口學特徵(性彆、年齡、職業、婚姻狀況和文化程度等)、可能感染HIV途徑、病程階段、抗病毒治療狀態、樣本來源、首次CD4+T淋巴細胞計數、病例隨訪狀況等.對HIV感染者和艾滋病患者的一般情況和失訪情況進行描述,應用Cox比例風險迴歸模型分析其失訪率影響因素.結果 1989-2012年現住阯為保山市的HIV感染者和艾滋病患者共3 295例,纍計觀察11 416.59人年,失訪222例,失訪率為0.0194/人年,其中2008年的失訪率最高,為0.052 8/人年,2012年失訪率最低,為0.006 2/人年.失訪者中,男性佔56.76％(126/222),失訪率為0.0204/人年,女性佔43.24％(96/222),失訪率為0.018 3/人年;戶籍為本市、本省其他市、外省、非中國國籍者分彆佔53.60％(119/222)、28.83％(64/222)、5.86％(13/222)、11.71％(26/222),失訪率分彆為0.012 5/人年、0.046 3/人年、0.0536/人年、0.095 6/人年;已接受和未接受抗病毒治療者分彆佔6.76％(15/222)、93.24％ (207/222),失訪率分彆為0.001 9/人年、0.058 8/人年;病程為艾滋病和HIV感染階段者分彆佔8.11％ (18/222)、91.89％(204/222),失訪率分彆為0.003 3/人年、0.034 5/人年;首次CD4+T淋巴細胞計數為＜ 200、200～350、＞350箇/ml者分彆佔4.95％(11/222)、73.87％(164/222)、21.17％ (47/222),失訪率分彆為0.004 8/人年、0.024 0/人年、0.020 3/人年.多因素Cox迴歸分析結果顯示:原籍為本省其他市(HR =3.11,95％ CI:2.28～4.25)、外省(HR =2.55,95％CI:1.42 ～4.56)、非中國國籍者(HR =2.12,95％ CI:I.35 ～3.33)失訪的風險均高于原籍為本市者;未接受抗病毒治療(HR=20.83,95％ CI:11.74 ～36.96)和病程為HIV感染階段者(HR =3.61,95％CI:1.82 ～7.16)失訪的風險分彆高于接受抗病毒治療和艾滋病階段者,而首次CD4+T淋巴細胞計數為200～ 350(HR=0.35,95％ CI:0.15 ～0.82)和＞350箇/ml者(HR =0.29,95％ CI:0.12 ～0.72)失訪的風險低于CD4+T淋巴細胞計數＜200箇/ml者;可能的感染途徑為註射毒品者(HR =0.60,95％CI:0.41～0.88)失訪風險低于異性傳播者.結論 現住阯為保山市HIV感染者和艾滋病患者的失訪率總體呈下降趨勢,非中國國籍及外地、異性性傳播、HIV感染者、首次CD4+T淋巴細胞計數＜200箇/ml的病例失訪風險較高.
목적 연구1989-2012년운남성보산시HIV감염자화애자병환자적실방솔급기영향인소.방법 통과중국질병예방공제신식계통적자계통“애자병종합방치신식계통”수집1989-2012년현주지위보산시적HIV감염자화애자병환자적상관신식,포괄일반인구학특정(성별、년령、직업、혼인상황화문화정도등)、가능감염HIV도경、병정계단、항병독치료상태、양본래원、수차CD4+T림파세포계수、병례수방상황등.대HIV감염자화애자병환자적일반정황화실방정황진행묘술,응용Cox비례풍험회귀모형분석기실방솔영향인소.결과 1989-2012년현주지위보산시적HIV감염자화애자병환자공3 295례,루계관찰11 416.59인년,실방222례,실방솔위0.0194/인년,기중2008년적실방솔최고,위0.052 8/인년,2012년실방솔최저,위0.006 2/인년.실방자중,남성점56.76％(126/222),실방솔위0.0204/인년,녀성점43.24％(96/222),실방솔위0.018 3/인년;호적위본시、본성기타시、외성、비중국국적자분별점53.60％(119/222)、28.83％(64/222)、5.86％(13/222)、11.71％(26/222),실방솔분별위0.012 5/인년、0.046 3/인년、0.0536/인년、0.095 6/인년;이접수화미접수항병독치료자분별점6.76％(15/222)、93.24％ (207/222),실방솔분별위0.001 9/인년、0.058 8/인년;병정위애자병화HIV감염계단자분별점8.11％ (18/222)、91.89％(204/222),실방솔분별위0.003 3/인년、0.034 5/인년;수차CD4+T림파세포계수위＜ 200、200～350、＞350개/ml자분별점4.95％(11/222)、73.87％(164/222)、21.17％ (47/222),실방솔분별위0.004 8/인년、0.024 0/인년、0.020 3/인년.다인소Cox회귀분석결과현시:원적위본성기타시(HR =3.11,95％ CI:2.28～4.25)、외성(HR =2.55,95％CI:1.42 ～4.56)、비중국국적자(HR =2.12,95％ CI:I.35 ～3.33)실방적풍험균고우원적위본시자;미접수항병독치료(HR=20.83,95％ CI:11.74 ～36.96)화병정위HIV감염계단자(HR =3.61,95％CI:1.82 ～7.16)실방적풍험분별고우접수항병독치료화애자병계단자,이수차CD4+T림파세포계수위200～ 350(HR=0.35,95％ CI:0.15 ～0.82)화＞350개/ml자(HR =0.29,95％ CI:0.12 ～0.72)실방적풍험저우CD4+T림파세포계수＜200개/ml자;가능적감염도경위주사독품자(HR =0.60,95％CI:0.41～0.88)실방풍험저우이성전파자.결론 현주지위보산시HIV감염자화애자병환자적실방솔총체정하강추세,비중국국적급외지、이성성전파、HIV감염자、수차CD4+T림파세포계수＜200개/ml적병례실방풍험교고.
Objective To determine the prevalence of loss to follow-up (PLF) and risk factors among human immunodeficiency virus (HIV) / acquired immunodeficiency syndrome (AIDS) patients from 1989 to 2012 in Baoshan city,Yunnan province.Methods The epidemic and follow-up databases of HIV/ AIDS patients by the end of 2012 were downloaded from "the history card downloading site" of HIV/AIDS database in China Information System for Disease Control and Prevention and obtained the related data of patients from 1989 to 2012 who had local residence in Baoshan city.These data included demographic characteristics (genders,age at the time of HIV testing positive,and occupation,marital status,and education levels,et al),transmission routes,and disease staging,antiretroviral therapy (ART),and sources of samples,the first CD4 + T cell counts,and status of follow-up,et al.Descriptive epidemiological study was used to describe the general characteristics of loss to follow-up.Multivariable Cox regression was used for determining risk factors associated with loss to follow-up.Results A total of 3 295 eligible HIV/ AIDS patients from 1989 to 2012 were included.The accumulative study person-year was 11 416.59 years,222 HIV/AIDS patients were lost to follow-up,and the PLF was 0.019 4/ person years (py).The highest PLF was 0.052 8/py in 2008,the lowest was 0.006 2/py in 2012.The lost patients included 56.76％ (126/222)males and 43.24％ (96/222) females,the PLFs were 0.020 4/py,0.018 3/py,respectively.Baoshan city,other cities in Yunnan province,and other provinces,foreign nationality as the family register reached 53.60％ (119/222),28.83％ (64/222),and 5.86％ (13/222),11.71％ (26/222),respectively,and their PLFs were 0.012 5/py,0.046 3/py,and 0.053 6/py,0.095 6/py,respectively.Receiving ART and not receiving ART occupied 6.76％ (15/222),93.24％ (207/222),respectively,and the PLFs were 0.001 9/py,0.0588/py.AIDS and HIV staging standed at 8.11％ (18/222),91.89％ (204/222),respectively,and the PLFs were 0.003 3,0.034 5/py.The first CD4 + T cell counts ＜ 200,200-350,and ＞ 350 cells/ml accounted for 4.95％ (11/222),73.87％ (164/222),21.17％ (47/222),respectively,and the PLFs were 0.004 8/py,0.024 0/py,0.020 3/py.The results of multivariable Cox regression showed the risks of loss to follow-up (RLFs) of family register as other cities in Yunnan province (HR =3.11,95％CI:2.28-4.25),other provinces(HR =2.55,95％ CI:1.42-4.56),and foreign nationality(HR =2.12,95％ CI:1.35-3.33)higher than that of Baoshan city,respectively.The RLFs of not receiving ART (HR =20.83,95％ CI:11.74-36.96) and HIV staging (HR =3.61,95％ CI:1.82-7.16) were higher than those of receiving ART and AIDS staging,respectively,moreover,the RFLs of the first CI4+T cell counts between 200-350 cells/ml(HR =0.35,95％ CI:0.15-0.82) and the first CD4+ T cell counts ＞ 350 cells/ml(HR =0.29,95％ CI:0.12-0.72)were less than that of first CD4 +T cell counts ＜ 200 cells/ml,respectively.The RLF of transmission route as injecting drug(HR =0.60,95％ CI:0.41-0.88)was less than that of heterosexual contact.Conclusion Overall,the prevalence of loss to follow-up among HIV/AIDS patients shows a downward trend,moreover,patients of outsiders,heterosexual contact,HIV staging,baseline CD4 + T cell counts ＜ 200 cells/ml are at higher risk of loss to follow-up.
