【摘要】 目的 分析北京市丰台区2018—2021年通过不同治疗转介模式开始艾滋病抗病毒治疗（ART）的男男性行为人群人类免疫缺陷病毒（HIV）/获得性免疫缺陷综合征（AIDS）治疗免疫学效果，并探讨其影响因素。方法 采用回顾性队列研究方法，利用艾滋病综合防治信息信息系统中2018—2021年通过一站式服务和其他机构转介2种模式进入队列的患者数据资料进行分析，采用χ~2检验和Mann-Whitney U检验比较不同治疗转介途径免疫学效果差异。采用Logistic回归模型分析抗病毒治疗免疫学效果的影响因素。结果 共纳入研究对象857例，其中一站式服务组589例（68.7%），其他机构组268例（31.3%）。一站式服务组确证后1个月开始ART的比例（89.5%）高于其他机构组（77.6%）（χ~2=21.23,P<0.01），基线处于世界卫生组织（WHO）期的比例（91.7%）高于其他机构组（85.1%）（χ~2=8.64,P<0.01）。一站式服务组随访第1年内CD4/CD8增幅高于其他机构组（Z=-2.85,P<0.01）。多因素logistics分析显示，MSM患者抗病毒治疗免疫学效果受年龄、随访状态、随访时间、初始治疗方案、基线CD4及基线CD4~+/CD8~+比值的影响。结论 社会组织与定点医院联合提供的检测治疗一站式服务在提高ART及时性、促进治疗效果方面发挥了积极的作用。更多还原

【Abstract】 Objective To analyze the immunological efficacy of antiviral therapy by different referral modes and its influencing factors among men who have sex with men with immunodeficiency virus/acquired immunodeficiency syndromes(HIV/AIDS) in Fengtai District of Beijing from 2018 to 2021. Methods A retrospective cohort study was conducted to analyze the data collected from National HIV/AIDS Information System referred by HIV/AIDS testing and treatment one-stop service and other case reporting institutions during 2018 —2021, and the Mann-Whitney U test and chi-square test were used to compare the immunological effect between different referral modes while a logistic regression model was used to analyze factors of immunological efficacy of antiviral therapy. Results A total number of 857 cases were enrolled with 589 cases(68.7%) referred by HIV/AIDS testing and treatment one-stop service, and 268 cases(31.3%)referred by case reporting institutions. The onestop-service group had a higher proportion(89.5%) of patients starting antiviral therapy within 1 month than the other institutions group(77.6%)（χ~2=21.23, P<0.01）. The proportion of WHO AIDS clinical stage Ⅰ in the Onestop-service group(91.7%) was higher than that in other institutions group(85.1%) （χ~2=8.64, P<0.01）. The increase of CD4~+/CD8~+T cells ratio in the one-stop-service group was higher than that in other institutions group within the first year of follow-up(Z=-2.85, P<0.01). Multivariate Logistic analysis revealed that age, follow-up status, follow-up time, initial treatment regimen, baseline CD4~+T cells and CD4~+/CD8~+T cells ratio were the factors influencing the success of immunological effects. Conclusion The one-stop service of HIV testing and treatment has played an active role in improving the timeliness and effectiveness of anti-retroviral therapy.更多还原