云南省德宏州接受抗病毒治疗的<b>HIV</b>感染者多病共患情况分析

杨锦; 李晓晗; 唐仁海; 高洁; 杨跃诚; 马中慧; 叶润华; 丁盈盈; 何纳; 段松

doi:10.19428/j.cnki.sjpm.2024.24145

云南省德宏州接受抗病毒治疗的HIV感染者多病共患情况分析

Prevalence of multimorbidity among the HIV-infected individuals receiving anti-viral therapy in Dehong Prefecture， Yunnan Province

摘要

摘要:
目的了解云南省德宏州接受抗病毒治疗（ART）的人类免疫缺陷病毒（HIV）感染者多病共患情况及影响因素，为HIV感染者长期随访管理和慢性病综合防治提供参考。
方法于2021年1—7月采用自行设计的问卷对德宏州接受ART的成年HIV感染者展开横断面调查，分析相关患病指标，使用多因素logistic回归模型分析影响因素。
结果共纳入研究对象3 946人，年龄以≤50岁（63.7%）者为主，男女比1.1∶1。其中，共有825例接受ART的HIV感染者有≥2种共患病，共患率为20.9%（95%CI：19.6%~22.2%），主要共患病为血脂异常、糖尿病、高血压。多因素logistic回归模型分析结果显示，年龄40~<50岁（aOR=1.86，95%CI：1.45~2.40，P<0.001）、年龄50~85岁（aOR=3.75，95%CI：2.93~4.80，P<0.001）、傣族（aOR=1.21，95%CI：1.01~1.47，P=0.043）、BMI≥24.0 kg∙m^-2（aOR=1.79，95%CI：1.49~2.14，P<0.001）、ART时长为10.0~<12.5年（aOR=1.49，95%CI：1.05~2.12，P=0.024）、ART时长≥12.5年（aOR=1.50，95%CI：1.05~2.15，P=0.026）、使用二线治疗方案（aOR=1.43，95%CI：1.19~1.70，P<0.001）和其他治疗方案（aOR=3.16，95%CI：2.17~4.61，P<0.001）与多病共患呈正相关。
结论德宏州接受ART的HIV感染者多病共患率较高，与年龄增长、患病治疗时间长相关，尤以血脂异常、糖尿病、高血压共病负担较高。未来需针对性加强共病的综合监测与ART随访管理。

Abstract:
Objective To explore the prevalence and influencing factors of multimorbidity among the HIV-infected individuals receiving anti-viral therapy (ART) in Dehong Prefecture of Yunnan Province, so as to provide a reference for the long-term follow-up management of HIV-infected patients and the comprehensive prevention and treatment of chronic diseases.
Methods A cross-sectional study was conducted to investigate the multimorbidity burden among the HIV-infected adults receiving ART in Dehong Prefecture from January to July 2021 and a self-designed questionnaire was used to analyze relevant disease indicators. Multivariate logistic regression analysis was used to investigate the influencing factors of multimorbidity among the HIV-infected individuals.
Results A total of 3 946 HIV-infected individuals receiving ART were enrolled in this study, of which 63.7% aged ≤50 years, with a male to female ratio of 1.1∶1. Among the 3 946 cases, 825 of them had ≥2 comorbidities, with a co-prevalence rate of 20.9% (95%CI:19.6%‒22.2%), and the main comorbidities were dyslipidemia, diabetes, and hypertension. Multivariate logistic regression analysis showed that 40≤ aged <50 years (aOR=1.86, 95%CI: 1.45‒2.40, P<0.001), 50≤ aged ≤85 years (aOR=3.75, 95%CI: 2.93‒4.80, P<0.001), Dai nationality (aOR=1.21, 95%CI: 1.01‒1.47, P=0.043), BMI≥24.0 kg∙m^-2 (aOR=1.79, 95%CI: 1.49‒2.14, P<0.001), 10.0≤ with ART duration for <12.5 years (aOR=1.49, 95%CI: 1.05‒2.12, P=0.024), with ART duration for ≥12.5 years (aOR=1.50, 95%CI: 1.05‒2.15, P=0.026), use of second-line HIV therapy (aOR=1.43, 95%CI: 1.19‒1.70, P<0.001) and other therapy options (aOR=3.16, 95%CI: 2.17‒4.61, P<0.001) were positively correlated with multimorbidity.
Conclusion The prevalence of multimorbidity among the HIV-infected individuals receiving ART in Dehong Prefecture is high, which is associated with the advancing age and prolonged treatment time, particularly with a significant burden of dyslipidemia, diabetes, and hypertension. Comprehensive surveillance and targeted management of comorbidities, along with ART follow-up, need to be strengthened in the future.

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