| BackgroundAIDS(Acquired Immune Deficiency Syndrome)is a kind of infectious disease that seriously endangers the physical and mental health of human beings.Since 1995,when Pingdingshan city of Henan province reported the first case of HIV(Human Immunodeficiency Virus)infection in a former paid blood donor because of irregular blood(Plasma)collection,the newly reported HIV/AIDS cases in the whole city show an increasing trend year by year.The analysis of HIV/AIDS epidemic situation plays an important role in the prevention and control of AIDS.It is an important means to evaluate the epidemic trend of AIDS,and the effect of prevention and control,and the detection rate of AIDS.Therefore,this study aims to explore the epidemic situation and trend of HIV/AIDS in Pingdingshan city from 2012 to 2021,and the effect of antiretroviral therapy on HIV/AIDS patients,to provide a scientific basis for the precise implementation of AIDS prevention and control in the region.ObjectiveAn analysis of the epidemiological characteristics of reported HIV/AIDS cases and the results of CD4~+T lymphocyte and viral load in Pingdingshan city from 2012 to 2021could shed light on the HIV/AIDS epidemic in Pingdingshan city in recent years,to identify the epidemic trend of HIV/AIDS and evaluate the effect of anti-viral therapy,and provide data support and scientific basis for aids-related project design,AIDS prevention and control publicity,and rational allocation of health resources,adjustment of integrated prevention and control strategies.Methods1.Download the epidemiological data of 2529 cases reported in Pingdingshan city from 2012 to 2021 from the"AIDS Prevention and Control Basic Information System"in the"China Disease Control and Prevention Information System",of which 1924 cases were confirmed by the AIDS confirmation laboratory of Pingdingshan CDC,and 605 cases were confirmed by other provinces and cities CDC or medical institutions.2.Download the data related to the antiviral treatment of cases from the"AIDS antiviral treatment"database(including the antiviral treatment plan and the baseline CD4~+T lymphocyte results before treatment),and count the results of laboratory testing of CD4~+T lymphocytes and HIV viral load after treatment from January 1,2021 to June 1,2022.A total of 1740 cases were included.3.Statistical methods were used to analyze the influencing factors of AIDS epidemiology(including current address,gender,age,marital status,education level,occupation,nationality,route of infection and mode of discovery)and the influencing factors of antiviral treatment effect(including CD4~+T lymphocyte,HIV viral load results and the antiviral treatment plan).Results1.Time distribution characteristics:From 2012 to 2021,a total of 2,529 HIV/AIDS cases and 369 deaths had been reported.The population-wide incidence of HIV/AIDS cases had increased from 2.97 per 100,000 in 2012 to 6.08 per 100,000 in the 2021;the mortality rate decreased from 0.58 per 100,000 in 2012 to 0.44 per 100,000 in 2012,showing a decreasing trend year by year(P<0.001);The results of the Joinpoint regression model showed that the infection rate of AIDS was on the rise from 2012 to 2021 period,with an average annual percentage change of(AAPC)7.3%.2.Regional distribution characteristics:All the 10 counties(cities and districts)in Pingdingshan city had reported HIV/AIDS cases,the highest number of reported cases was in Lushan County(20.60%),followed by Ye County(16.81%).3.Population distribution characteristics:Male cases were more than female cases,the ratio of male to female was 3.83:1,the proportion of male cases was increasing year by year(P<0.001),the average age of cases was 42.56±16.07 years old,the constituent ratio of 20-49 years old group was 63.62%,the constituent ratio of 50 years old and over group was 32.62%,the constituent ratio of 50 years old and over group was increasing year by year(P<0.001).The main educational level was a junior middle school(42.82%),the main ethnic group was Han nationality(97.90%);and the occupation distribution was diversified,mainly farmers(61.45%).4.Characteristics of infection route and detection mode:The main transmission route was non-marital heterosexual sex(62.59%),and the proportion of male-to-male sexual transmission was increasing year by year(P<0.01);there were significant differences in infection routes among different age groups and different marital statuses(P<0.001).The main mode of case finding was passive detection in medical institutions(53.19%),The second is voluntary counseling and testing of disease control system(35.51%),the number of detected cases in medical institutions increased year by year(P<0.001).5.Antiviral treatment characteristics:The CD4~+T cells count was 446.27±227.99cells/μl in the last follow-up test after treatment of 1740 cases,higher than the baseline CD4~+T cell count before treatment(290.90±198.56)cells/μl.The range of CD4~+T cells count before treatment most was less than 200 cells/μl(35.62%),and the range of CD4~+T cells count after treatment most was more than 500 cells/μl(33.97%).94.25%cases had viral load<400 copies/ml in the last follow-up test after antiviral treatment;The distribution of CD4~+T cells before and after antiviral treatment,the distribution of patients with different CD4~+T cells after antiviral treatment and the results of viral load were statistically significant(P<0.001).In the anti-virus treatment plan,the initial treatment plan and the latest treatment plan were mainly the first-line treatment plan 3TC+TDF+EFV,with75.69%and 71.84%respectively;In the initial treatment and the latest treatment scheme,the second-line treatment scheme was used in3.74%and 8.05%,respectively,of which the second-line treatment scheme of 3TC+TDF+LVP/r was mainly used.ConclusionIn Pingdingshan city from 2012 to 2021,the majority of reported HIV/AIDS cases were male,married couples and farmers;the main route of infection was non-marital heterosexual sex,and the number of homosexual transmissions and the elderly cases increased year by year;passive detection is the main method.In the process of AIDS prevention and control,we should pay more attention to such groups,strengthen AIDS prevention and control publicity,and continue to promote the expansion of AIDS testing strategy,early detection,and early treatment,to reduce the spread of AIDS. |
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