Center for Disease Control and Prevention of Anhui Province, Hefei, China; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China.
J Med Virol. 2015 Jun;87(6):970-7. doi: 10.1002/jmv.24066. Epub 2015 Mar 10.
While highly active antiretroviral therapy has been successful in delaying progression into AIDS, late HIV diagnosis remains a major contributor to the mortality and morbidity of AIDS. An epidemiological study was conducted to evaluate the prevalence and factors of late diagnosis and the characteristics of those individuals with late diagnosis in Liuzhou city. Patients with late diagnosis were defined as either those who were diagnosed with AIDS at the time of HIV diagnosis or as those who developed AIDS no more than 1 year after HIV diagnosis. Of 899 participants, 72.6% had a late diagnosis. Common characteristics of those who experienced late diagnosis included older participants, those who were unexpectedly diagnosed while seeking other medical attention, participants who believed they could not acquire HIV from their regular heterosexual partners, those who never considered getting tested for HIV, and patients with unexplained weight loss, angular cheilitis, or prolonged fever prior to HIV diagnosis. On the other hand, those participants who were diagnosed via testing at compulsory rehabilitation centers and those whose annual household income was greater than 30,000 Yuan were less likely to be diagnosed late. These results suggested that late HIV diagnosis is common in Liuzhou city, and it is essential to promote appropriate strategies to detect HIV infections earlier. Strategies that require HIV/AIDS patients to notify their spouse/sexual-partners about their HIV-positive results within one month and start provider-initiated HIV testing and counseling in medical facilities are beneficial to earlier HIV diagnosis.
虽然高效抗逆转录病毒疗法在延缓艾滋病进展方面取得了成功，但艾滋病的死亡率和发病率仍然与艾滋病晚期诊断有关。本研究旨在评估柳州市艾滋病晚期诊断的流行情况及其影响因素和特征。艾滋病晚期诊断定义为艾滋病诊断时已处于艾滋病期或艾滋病诊断后 1 年内进展为艾滋病期。899 名参与者中，72.6%为艾滋病晚期诊断。艾滋病晚期诊断的常见特征包括：年龄较大、因其他疾病就诊时偶然诊断、认为自己不能从常规异性性伴感染 HIV、从未考虑过 HIV 检测、有不明原因的体重减轻、口角炎或发热时间较长。相比之下，在强制戒毒所诊断和家庭年收入超过 3 万元的参与者不太可能出现艾滋病晚期诊断。研究结果表明，柳州市艾滋病晚期诊断较为常见，需要采取适当措施，以便更早地发现 HIV 感染。需要 HIV/AIDS 患者在 1 个月内通知配偶/性伴侣其 HIV 阳性结果，并在医疗机构开展由医务人员主动提供的 HIV 检测和咨询，这些策略有助于更早地发现 HIV。
