CAJ | 학술논문

目的：回顾和总结云南省成人和青少年AIDS抗病毒治疗10年结果，讨论取得的成绩和存在的问题。方法利用《艾滋病综合防治系统———抗病毒治疗管理》数据库的数据进行统计分析。结果云南省的治疗人数和覆盖率都有了显著增长，在50241例进行过抗病毒治疗的患者中，截至2013年12月底仍然继续治疗的占82.3%；感染途径为静脉吸毒患者的失访、停药和病死率显著高于性途径感染者；患者的治疗基线CD4+T淋巴细胞计数越低，治疗期间的病死率越高；1年的治疗队列中，基线CD4+T淋巴细胞计数<350个/mm3患者的终止治疗率低于CD4+T淋巴细胞计数≥350个/mm3的患者；治疗第1年的患者治疗保持情况不佳，停药、失访和病死率较后期的高；治疗6个月以上的患者有82.9%达到病毒检测不到水平；耐药率低于5%；接受治疗患者的病死率逐年下降，已经低于2%。结论云南省抗病毒治疗取得了一定的成绩，但在扩大治疗的策略和目前情况下仍然面临着挑战。
목적：회고화총결운남성성인화청소년AIDS항병독치료10년결과，토론취득적성적화존재적문제。방법이용《애자병종합방치계통———항병독치료관리》수거고적수거진행통계분석。결과운남성적치료인수화복개솔도유료현저증장，재50241례진행과항병독치료적환자중，절지2013년12월저잉연계속치료적점82.3%；감염도경위정맥흡독환자적실방、정약화병사솔현저고우성도경감염자；환자적치료기선CD4+T림파세포계수월저，치료기간적병사솔월고；1년적치료대렬중，기선CD4+T림파세포계수<350개/mm3환자적종지치료솔저우CD4+T림파세포계수≥350개/mm3적환자；치료제1년적환자치료보지정황불가，정약、실방화병사솔교후기적고；치료6개월이상적환자유82.9%체도병독검측불도수평；내약솔저우5%；접수치료환자적병사솔축년하강，이경저우2%。결론운남성항병독치료취득료일정적성적，단재확대치료적책략화목전정황하잉연면림착도전。
Objective To retrospectively analyze the 10-year outcomes of free antiretroviral therapy (ART) for HIV/AIDS adults and adolescents in Yunnan Province and to discuss the achievements and challenges. Method Statistical analysis was made by using the data from AIDS Control and Prevention System:Management of Antiretroviral Therapy. Results The number and coverage of people receiving free ART increased markedly since 2004;by the end of 2013, 82.3%of the cumulative 50 241 patients had been continuing the treatment;the rates of loss-to-follow-up, drug withdrawal and mortality in injecting drug users were significantly higher than those in patients infected by sexual transmission;the patients with lower baseline CD4+T lymphocyte count had higher mortality;in the 1-year ART cohort, the treatment termination rate of patients with baseline CD4+T lymphocyte count<350/mm3 was lower than that of patients with CD4+T lymphocyte count≥350/mm3;during the first year after starting ART, the rates of the loss-to-follow-up, drug withdrawal and mortality were higher than those in the later treatment duration;the undetectable rate of HIV was 82.9%in patients receiving more than 6 months of treatment;the resistance rate was less than 5%;the annual mortality rate reduced to below 2%. Conclusion Yunnan Province has made much progress in ART for AIDS patients, but there are challenges to be tackled in making strategies for enlarging the coverage of treatment.