全国艾滋病综合防治示范区50岁及以上新报告HIV/AIDS特征及首次CD4<sup>+</sup>T淋巴细胞检测情况分析

岳青; 刘玉芬; 李慧; 赵媛

Abstract

岳青,刘玉芬,李慧,赵媛.全国艾滋病综合防治示范区50岁及以上新报告HIV/AIDS特征及首次CD4⁺T淋巴细胞检测情况分析[J].Chinese journal of Epidemiology,2021,42(10):1823-1828

全国艾滋病综合防治示范区50岁及以上新报告HIV/AIDS特征及首次CD4⁺T淋巴细胞检测情况分析

Characteristics and the first CD4⁺T lymphocytes test of newly-reported HIV/AIDS cases aged 50 years and above in the third round of China comprehensive AIDS response program

Received:April 06, 2021

DOI：10.3760/cma.j.cn112338-20210331-00199

KeyWord: 艾滋病病毒/艾滋病老年人特征 CD4⁺T淋巴细胞全国艾滋病综合防治示范区

English Key Word: HIV/AIDS Older adults Characteristics CD4⁺ T lymphocyte China comprehensive AIDS response program

FundProject:

Author Name	Affiliation	E-mail
Yue Qing	National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Liu Yufen	National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China	yufenliu69@chinaaids.cn
Li Hui	National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Zhao Yuan	National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China

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Abstract:

目的了解第三轮全国艾滋病综合防治示范区（示范区）≥50岁新报告HIV/AIDS特征和首次CD4⁺T淋巴细胞（CD4）检测情况。方法资料来源于中国疾病预防控制信息系统艾滋病防治基本信息系统，收集2014-2018年≥50岁新报告HIV/AIDS的资料，用Cochran-Armitage趋势检验和多因素logistic回归做统计分析。结果 2014、2015、2016、2017和2018年示范区≥50岁新报告HIV/AIDS分别为8 288、9 512、11 315、13 091和14 673例，共计56 879例。以男性为主（75.7%）；传播途径以异性性传播为主（87.8%）；样本来源以医疗机构为主（68.6%）。HIV/AIDS确诊HIV感染后10个工作日内完成首次CD4检测的比例为69.6%。在29 078例确诊HIV感染后即进行首次CD4检测的HIV/AIDS中，CD4<200个/μl和≤500个/μl的比例分别为66.5%和93.8%。首次CD4检测及时的相关因素logistic回归分析结果显示，与小学及以下文化程度相比，初中、高中或中专和大专及以上者的OR值（95%CI）分别为1.113（1.063~1.166）、1.205（1.128~1.289）和1.277（1.160~1.406）；与50~59岁相比，70~79岁和≥80岁的OR值（95%CI）分别为0.864（0.816~0.914）和0.612（0.554~0.676）；与检测咨询点样本来源相比，医疗机构样本来源的OR值（95%CI）为0.750（0.714~0.788）。结论示范区≥50岁新报告HIV/AIDS逐年增加，以男性和既往感染为主。CD4检测及时的比例稳步提升，影响CD4检测及时的主要因素包括小学及以下文化程度、年龄≥70岁和医疗机构样本来源。示范区应重点加强老年人艾滋病的早预防和早发现。

English Abstract:

Objective To understand the characteristics and the first CD4⁺T lymphocytes (CD4) test of newly-reported HIV/AIDS cases aged 50 years and above in the third round of China comprehensive AIDS response (CARES) program. Methods The data of newly-reported HIV/AIDS cases aged 50 years and above from 2014 to 2018 were collected from the National Information system for HIV/AIDS Control and Prevention of Chinese System for Disease Control and Prevention. The Cochran-Armitage trend test and multivariate logistic regression were used for statistical analysis.Results There were 8 288, 9 512, 11 315, 13 091, and 14 673 newly-reported cases of HIV/AIDS aged 50 years and above in the third round of China CARES in 2014, 2015, 2016, 2017, and 2018, respectively, for a total of 56 879 cases. The majority of cases were male (75.7%). The main route of transmission was heterosexual transmission (87.8%). Most of the cases were diagnosed by medical institutions (68.6%). 69.6% of HIV/AIDS cases completed the first CD4 test within 10 working days after the diagnosis of HIV infection. Among the 29 078 HIV/AIDS cases who had their first CD4 test immediately after diagnosis of HIV infection, the proportions of CD4 cell count <200 cells/μl and <500 cells/μl were 66.5% and 93.8%, respectively. The results of logistic regression analysis of the factors related to the first CD4 test immediately showed that, compared to cases with an education level of elementary school and below, OR (95%CI) values for timely CD4 testing of cases with an education level of junior high school, high school or technical secondary school and junior college or above were 1.113 (1.063-1.166), 1.205 (1.128-1.289) and 1.277 (1.160-1.406) respectively. Compared to cases aged 50-59 years, OR (95%CI) values for timely CD4 testing of cases aged 70-79 years and ≥ 80 years were 0.864 (0.816-0.914) and 0.612 (0.554-0.676), respectively. Compared to cases diagnosed by HIV voluntary counseling and testing, OR (95%CI) value for timely CD4 testing of cases diagnosed by medical institutions was 0.750 (0.714-0.788). Conclusions The number of newly reported HIV/AIDS cases aged 50 and above was increasing year by year in the third round of China CARES, with a predominance of men and previous infections. The proportion of timely CD4 tests was drastically increasing. The factors associated with timely CD4 test included primary school or below education level, ≥ 70 years old, and cases diagnosed by medical institutions. The third round of China CARES should focus on strengthening the prevention of AIDS and early detection of HIV/AIDS cases among the elderly.

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