【摘要】 目的 了解2019—2021年秦皇岛地区HIV/AIDS患者首次接受抗病毒治疗的效果，为进一步完善秦皇岛地区AIDS抗病毒治疗工作提供参考依据。方法 收集2019—2021年底在秦皇岛地区内接受AIDS抗病毒治疗的18岁及以上HIV/AIDS感染者和AIDS患者基线和抗病毒治疗6个月后的相关资料，分析抗病毒治疗效果。结果 450例患者在抗病毒治疗6个月后，病毒抑制失败24例，病毒抑制失败率为5.33%;多因素分析结果显示，相较于青年人群，中年（OR=1.269, 95%CI:1.025～1.571）和老年人群（OR=1.645, 95%CI:1.165～2.323）,在抗病毒治疗6个月后，病毒抑制失败的风险较高（P=0.029）;相较于确诊与治疗时间间隔<6个月，间隔时间≥6个月（OR=1.650, 95%CI:1.142～2.386）病毒抑制失败的风险较高（P=0.008）;相较于基线CD₄⁺T淋巴细胞计数<200个/μl的患者，基线CD₄⁺T淋巴细胞计数为350～499个/μl（OR=0.752, 95%CI:0.632～0.895）和500个/μl以上（OR=0.672, 95%CI:0.534～0.845）的人群，病毒抑制失败的风险较低；临床分期为Ⅲ～Ⅳ（OR=1.594, 95%CI:1.267～2.004）、采用其他治疗方案（OR=1.422, 95%CI:1.058～1.912）、漏服药物（OR=1.487, 95%CI:1.194～1.852）、具有药物不良反应（OR=1.507, 95%CI:1.186～1.914）的患者病毒抑制失败的风险较高。结论 秦皇岛地区AIDS免费抗病毒治疗仍有部分患者抗病毒治疗效果失败。应重点关注中老年HIV/AIDS人群的治疗效果。此外，早发现、早诊断、早治疗以及提高患者的依从性对提升抗病毒治疗效果至关重要；抗病毒治疗受到近2年新冠疫情的影响，导致有的患者不能按时来取药用药。更多还原

【Abstract】 Objective To investigate the efficacy of initial antiviral treatment in patients with human immunodeficiency virus（HIV） infection/acquired immunodeficiency syndrome（AIDS） in Qinhuangdao from 2019 to 2021, and to provide a reference basis for further improving HIV/AIDS antiviral treatment in Qinhuangdao. Methods We recruited the baseline data about HIV-infected persons/AIDS patients aged 18 years and above who received antiviral treatment for HIV/AIDS and the related data after 6 months of antiviral treatment in Qinhuangdao during 2019-2021, and then analyzed the effect of antiviral therapy. Results After 6 months of antiviral treatment, 24 out of 450 HIV/AIDS patients had virological suppression failure, with the virological suppression failure rate being 5.33%. The results of multi-factor analysis revealed that the middle-aged population（OR=1.269, 95%CI: 1.025-1.571） and the elderly population（OR=1.645, 95%CI:1.165-2.323） had a higher risk of virological suppression failure（P=0.029） after 6 months of antiviral treatment than the young population. Compared with the time interval between diagnosis and treatment of < 6 months, the risk of virological suppression failure in the time interval between diagnosis and treatment of ≥ 6 months（OR=1.650, 95%CI:1.142-2.386） was higher（P=0.008）. Patients with baseline CD⁺₄ T lymphocyte counts 350-499 cells/μl（OR=0.752, 95%CI:0.632-0.895） and > 500 cells/μl（OR=0.672, 95%CI: 0.534-0.845） had a lower risk of virological suppression failure than those with baseline CD⁺₄ T lymphocyte count <200 cells/μl. Patients with clinical stages III-IV（OR=1.594, 95%CI:1.267-2.004）, other treatment regimens（OR=1.422, 95%CI: 1.058-1.912）, missed medication（OR=1.487, 95%CI: 1.194-1.852） and adverse drug reactions（OR=1.507, 95%CI: 1.186-1.914） had a higher risk of virological suppression failure. Conclusion There are still some HIV/AIDS patients who fail to achieve virus suppression in antiviral therapy for HIV/AIDS offered free in Qinhuangdao. Special attention should be paid to the therapeutic effect among the middle-aged and elderly populations with HIV/AIDS. In addition, early detection, early diagnosis, early treatment and promoting patients’ compliance are crucial for improving the effect of antiviral therapy. Antiviral treatment has been affected by the SARS-CoV-2 pandemic in the last two years, thus leading to some patients being unable to get and take the medicine on time.更多还原