| Objective:To summarize the epidemiological characteristics,clinical characteristics,diagnosis,treatment and outcome of 550 HIV/AIDS patients reported in Yan’an city from 2004 to 2021,and to provide scientific basis for AIDS prevention and control and rational allocation of medical resources in Yan’an City.Method:570 cases of clinical data of HIV/AIDS patients reported and documented in Yan’an city were derived from the AIDS Comprehensive Prevention and Control Data Information System,a subsystem of Chinese Disease Prevention and Control Information System.All 550 patients with HIV antibody diagnosed between January 1,2004 and December 31,2021were screened and included in the study.According to the research contents,the derived data items were supplemented to form the initial database.Handle outliers,duplicates,and missing values,find variable names for assignment,group some continuous variables,and process data with SPSS25.0.Results:1.Epidemiological characteristics1.1 Population distribution,time distribution and regional distribution of the research objectsAmong 550 HIV/AIDS patients reported in Yan’an City from 2004 to2021,male(88.0%),25-50 years old(67.27%),married or cohabitant(55.82%),farmer(57.27%),and junior high school education(36.73%)accounted for the most.The number of cases in 2009 was the least,with 1patient(0.18%).The highest number of cases was 79(14.36%)in 2019.In2004,no HIV infected persons were found in Yan’an city.The population incidence was 0.14/100,000 in 2005,and increased to 3.22/100,000 in 2021;the prevalence was 0.14/100,000 in 2005,and increased to 24.24/100,000 in2021.Both incidence and prevalence showed an increasing trend year by year(P<0.05).Among the registered places of patients,the county(city,district)of Yan’an city was the most,with 513 cases(93.27%).26 cases(4.73%)were reported in other prefectures of the province.Other provinces reported 10cases(1.82%).1.2 Source of test samples and route of infection of research objectsAmong 550 HIV/AIDS patients reported in Yan’an City from 2004 to2021,24.18%of them knew their own infection status through active consultation and testing,and 26.55%of them found their own infection status through passive testing.Heterosexual transmission was the most common route of infection,340 cases(61.82%).The second was homosexual transmission,with 189 cases(34.37%).There were 21 cases(3.82%)of injecting drug use,mother-to-child transmission,transmission through blood and blood products and other routes of infection.2.Clinical features2.1 Symptoms/Signs,opportunistic infections/complicationsAmong 550 HIV/AIDS patients reported in Yan’an City from 2004 to2021,73 cases(13.27%)showed symptoms/signs such as fever,cough,diarrhea,night sweats,dyspnea and headache.Opportunistic infection occurred in 39 cases(7.10%);PCP was the most common in 11 cases(2.00%),followed by oral hairy leukoplakia(1.27%)in 7 cases.There were 99 cases(18.00%)with complications,the most cases were Viral hepatitis B(53 cases(9.64%),Viral hepatitis C(8 cases(1.45%),syphilis(38 cases).2.2 Levels of CD4~+T cells and HIV viral loadAmong 550 HIV/AIDS patients reported in Yan’an City from 2004 to2021,70 patients(12.82%)had less than 100 CD4~+T cells/ul before treatment,and 98 patients(17.95%)had 100～200 CD4~+T cells/ul.There were85 patients(15.57%)with CD4~+T cells≥500/ul.There were 23 patients(4.21%)with CD4~+T cells less than 100/ul after treatment.There were 43patients(7.88%)with 100～200 CD4~+T cells/ul,and 233 patients(42.67%)with≥500 CD4~+T cells/ul.There were 116 cases(42.34%)with viral load<1000Copies/ml before treatment,51 cases(18.61%)with viral load between 5000 and100000Copies/ml,and 89 cases(32.48%)with viral load≥100000Copies/ml.There were 247 cases(70.98%)with viral load<1000Copies/ml,31 cases(8.91%)with viral load between 5000 and100000Copies/ml,and 46 cases(13.22%)with viral load≥100000Copies/ml.2.3 Treatment and outcomeAmong the 550 HIV/AIDS patients reported in Yan’an City from 2004to 2021,529(96.18%)were alive,21(3.82%)were dead,and 23(4.18%)were lost to follow-up,transferred or drug withdrawal.Currently 506 cases(92.00%)are receiving antiviral treatment.3TC+EFV+TDF was dominant in initial and current antiviral treatment,87.54%and 80.12%,respectively.Patients using EVG/c/FTC/TAF increased from 2.36%to 4.53%in initial treatment and from 0.36%to 1.57%in BIC/FTC/TAF in current treatment.Conclusion:1.Epidemiological characteristicsAmong the 550 HIV/AIDS patients in Yan’an City from 2004 to 2021,the majority were male,married or cohabiting,25-50 years old,farmers,junior high school education,and unmarried,college education or above,and business service personnel accounted for a certain proportion.The number of new cases increased year by year,mainly in Yan’an City;Mainly to detect their own infection status;The main way of transmission is sexual transmission,and heterosexual transmission is the most common.2.Clinical featuresAmong 550 patients with HIV/AIDS in Yan’an City from 2004 to 2021,the most common symptom was fever,the most common opportunistic infection was PCP,and the most common complication was viral hepatitis B.The main treatment regimen was 3TC+EFV+TDF,and some patients began to try new antiviral therapy.It suggests that in the future in the prevention of AIDS in the process to increase the AIDS publicity efforts,not only to improve the detection rate of married spouses,but also need to focus on non-marital heterosexual sex,take effective measures to cut off the way of sexual transmission,early detection,early diagnosis,early treatment,reduce the incidence of opportunistic infections and complications. |
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