新发 HIV/AIDS 患者的流行病学和临床特征：16 年变化趋势的回顾性分析。

Epidemiological and Clinical Profile of Newly Diagnosed HIV/AIDS Patients: A Retrospective Analysis of Changing Trends Over 16 Years.

机构信息

Department of Infectious Diseases and Clinical Microbiology, Istanbul Haseki Training and Research Hospital, Istanbul, Turkey.

Department of Public Health, Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Istanbul, Turkey.

出版信息

Curr HIV Res. 2023;21(1):35-42. doi: 10.2174/1570162X21666230111150431.

DOI:10.2174/1570162X21666230111150431

PMID:36631925

Abstract

OBJECTIVE

To evaluate the epidemiological profile and clinical findings of newly diagnosed HIV-infected patients in terms of changing trends over 16 years.

METHODS

A total of 748 patients (mean ± SD age: 34 ± 11.6 years, 88.9% were males) newly diagnosed with HIV/AIDS at a tertiary care hospital located in Istanbul province between 2002 and 2017 were included in this retrospective study. Data on sociodemographic characteristics, potential routes of transmission, the reason for HIV testing, time from diagnosis to treatment onset, and the HIV RNA values and CD4 T cell count (at diagnosis and treatment onset) were recorded in each patient and compared between the diagnoses made within the 2002-2009 (n = 141) vs. 2010-2017 (n = 607) periods.

RESULTS

When compared to HIV diagnoses within the 2002-2009 period, the diagnoses made within the 2010-2017 period were associated with a significantly higher percentage of males (78.7 vs. 91.3%, p < 0.001), 18-29 years age group (23.6% vs. 35.5%, p = 0.029), singles (34.0 vs. 49.6%, p = 0.004), university graduates (9.9 vs. 23.4%, p < 0.001) and students (0.7 vs. 8.2%, p < 0.001) along with an increased likelihood of voluntary testing (6.4 vs. 15.2%, p = 0.048) and a lower percentage of heterosexual individuals (63.8 vs. 47.0%, p < 0.001). Sexual contact (88.0%) was the leading transmission route, and the presence of complaints (44.3%) was the leading reason for HIV testing. Overall, the time from diagnosis to treatment onset was a median 1 month (range, 1 to 97 months), and the median HIV RNA level at the time of diagnosis was 208065 copies/mL with no significant difference between study periods. The diagnoses within the 2010-2017 vs. 2002-2009 period were associated with significantly higher median (min-max) CD4 T cell counts (378(0-2522) vs. 319(4-1270) cells/mm, p < 0.001) and a lower percentage of patients with CD4 T cell count < 200 cells/mm (22.1 vs. 39.0%, p = 0.002) at the time of diagnosis.

CONCLUSION

In conclusion, our findings on the epidemiological profile and clinical characteristics of newly diagnosed HIV patients over 16 years (2002-2017) in a tertiary care center in Turkey revealed a considerable increase in the number of new diagnoses, an improved earlier diagnosis and a change in epidemiologic profile over the years with increased likelihood of disease to be more commonly diagnosed among males, 18-29 years age group and MSM.

摘要

目的

评估在过去 16 年中，新诊断的 HIV 感染患者的流行病学特征和临床发现，以了解其变化趋势。

方法

本研究回顾性分析了 2002 年至 2017 年期间在伊斯坦布尔省一家三级保健医院新诊断为 HIV/AIDS 的 748 例患者（平均年龄 ± 标准差：34 ± 11.6 岁，88.9%为男性）。记录每位患者的社会人口统计学特征、潜在传播途径、HIV 检测原因、从诊断到治疗开始的时间以及 HIV RNA 值和 CD4 T 细胞计数（诊断时和治疗开始时），并比较 2002-2009 年（n = 141）和 2010-2017 年（n = 607）期间的诊断结果。

结果

与 2002-2009 年期间的 HIV 诊断相比，2010-2017 年期间的诊断与更高比例的男性（78.7% vs. 91.3%，p < 0.001）、18-29 岁年龄组（23.6% vs. 35.5%，p = 0.029）、单身（34.0% vs. 49.6%，p = 0.004）、大学毕业生（9.9% vs. 23.4%，p < 0.001）和学生（0.7% vs. 8.2%，p < 0.001）有关，同时自愿检测的可能性增加（6.4% vs. 15.2%，p = 0.048），异性恋者的比例降低（63.8% vs. 47.0%，p < 0.001）。性接触（88.0%）是主要的传播途径，出现症状（44.3%）是 HIV 检测的主要原因。总体而言，从诊断到治疗开始的时间中位数为 1 个月（范围为 1 至 97 个月），诊断时 HIV RNA 水平的中位数为 208065 拷贝/ml，两个研究期间无显著差异。2010-2017 年与 2002-2009 年相比，诊断时 CD4 T 细胞计数（中位数（最小值-最大值）：378（0-2522） vs. 319（4-1270）个/ mm3，p < 0.001）更高，CD4 T 细胞计数 < 200 个/ mm3 的患者比例更低（22.1% vs. 39.0%，p = 0.002）。