HIV late presentation and advanced HIV disease among patients with newly diagnosed HIV/AIDS in Southwestern China: a large-scale cross-sectional study
HIV late presentation and advanced HIV disease among patients with newly diagnosed HIV/AIDS in Southwestern China: a large-scale cross-sectional study
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中国西南地区新诊断艾滋病毒/艾滋病患者的艾滋病毒晚期表现和晚期艾滋病毒疾病：一项大规模横断面研究
DOI：
10.1186/s12981-019-0221-7
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发表时间：
2019-03-16
影响因子：
2.2
通讯作者：
Liang, Hao
中科院分区：
文献类型：
--
作者：
Hu, Xi;Liang, Bingyu;Liang, Hao
目的了解广西壮族自治区新发HIV/AIDS患者HIV晚期表现和晚期疾病的流行情况，并探讨与HIV晚期表现和晚期疾病相关的因素。方法选取2012年1月至2016年12月在广西疾病预防控制中心HIV监测系统登记的新诊断HIV患者。结果45118例新确诊患者中，70.2%出现较晚，45.1%出现晚期艾滋病。男性异性恋者和女性吸毒者（PWID）中出现晚期和晚期艾滋病毒疾病的比例较高。异性恋（OR 2.11 [95% CI 1.90-2.34]）和PWID （OR 1.55 [95% CI 1.30-1.84]）比男男性行为者（MSM）有更高的延迟出现风险。接受血液检测的患者（OR为1.75 [95% CI 1.36-2.26]）和在医院确诊的患者（OR为1.74 [95% CI 1.65-1.84]）与通过自愿咨询和检测（VCT）确诊的患者相比，出现迟发症状的风险更高。异性恋（OR 2.86 [95% CI 2.51-3.27]）、PWID （OR 2.23 [95% CI 1.83-2.71]）、接受血液检测（OR 1.58 [95% CI 1.29-1.94]）和住院诊断（OR 1.85 [95% CI 1.76-1.94]）也是与晚期HIV疾病相关的独立危险因素。年龄较大、受教育程度较低、离婚或丧偶也与较晚出现和晚期艾滋病毒疾病有关。结论2012-2016年广西新发HIV患者中，HIV表现和晚期疾病非常普遍。广西迫切需要有针对性的项目来减少艾滋病的晚期诊断，特别是男性异性恋、PWID以及年龄较大、受教育程度较低、离婚或丧偶等特征的患者。
ObjectiveThis study aimed to investigate the prevalence of HIV late presentation and advanced HIV disease and to identify the factors associated with HIV late presentation and advanced HIV disease among patients with newly diagnosed HIV/AIDS in the Guangxi Zhuang Autonomous Region, in Southwestern China.MethodsPatients with newly diagnosed HIV registered in the HIV surveillance system of Guangxi Centers for Disease Control between January 2012 and December 2016 were included in this study.ResultsOf 45,118 newly diagnosed patients, 70.2% had late presentation, and 45.1% had advanced HIV disease. A higher prevalence of late presentation and advanced HIV disease was found in male heterosexuals and female people who use drugs (PWID). Heterosexuals (OR 2.11 [95% CI 1.90–2.34]) and PWID (OR 1.55 [95% CI 1.30–1.84]) had a higher risk of late presentation than men who have sex with men (MSM). Blood testing of the blood receivers (OR 1.75 [95% CI 1.36–2.26]) and diagnosed in hospital (OR 1.74 [95% CI 1.65–1.84]) had an increased risk of late presentation compared to those who diagnosis in voluntary counseling and testing (VCT). Heterosexuals (OR 2.86 [95% CI 2.51–3.27]), PWID (OR 2.23 [95% CI 1.83–2.71]), blood testing of the blood receivers (OR 1.58 [95% CI 1.29–1.94]) and diagnosed in hospital (OR 1.85 [95% CI 1.76–1.94]) were also independent risk factors associated with advanced HIV disease. Older age, lower level of education and being divorced or widowed were also associated with late presentation and advanced HIV disease.ConclusionsLate presentation and advanced HIV disease were very common among patients with newly diagnosed HIV in Guangxi, China during 2012–2016. Targeted programs are urgently required to reduce HIV late diagnosis in Guangxi, especially for male heterosexuals, PWID, and patients with characteristics such as older age, lower level of education, divorced or widowed.