[2021年江苏省新报告HIV/AIDS患者贫血发生率及危险因素分析]。

Q3 Medicine

中国血吸虫病防治杂志 Pub Date : 2024-12-09 DOI:10.16250/j.32.1915.2024174

Z Zhang, Q Sun, T Qiu, P Ding, B Wang, B Zhu

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The risk factors of anemia were identified among individuals living with HIV infections using univariate analysis and multivariate logistic regression analysis. In addition, subjects' CD4 cell counts one year following antiretroviral therapy (ART) were retrieved from China's National AIDS Comprehensive Control Information Management System, and compared between subjects with and without anemia.Results: A total of 635 newly diagnosed HIV/AIDS patients were reported in Jiangsu Province in 2021, including 544 males (85.67%) and 91 females (14.33%), and with ages of 15 to 83 years, and the overall incidence of anemia was 5.51% (35/635) among the study subjects. Men, individuals at ages of 45 years and lower and workers had relatively higher hemoglobin levels, with median hemoglobin levels of 156 (interquartile range, 22), 154 (interquartile range, 23) g/L and 162 (interquartile range, 19) g/L, respectively. The median baseline HIV viral load was 40 500.00 (interquartile range, 119 735.00) copies/mL among HIV-infected individuals with anemia and 29 754.00 (69 183.00) copies/mL among those without anemia (Z = -0.91, P = 0.31), and the median baseline CD4 and CD8 cell counts were significantly lower among HIV-infected individuals with anemia [166 (interquartile range, 143) cells/μL and 755 (653) cells/μL] than those without anemia [308 (253) cells/μL and 892 (638) cells/μL] (Z = -4.36 and -2.37, both P values < 0.05). The median CD4 cell counts remained lower among HIV-infected individuals with anemia than those without anemia [296 (interquartile range, 229) cells/μL vs. 457 (interquartile range, 313) cells/μL; Z = -3.71, P < 0.05] one year following ART, and the proportions of moderate and severe immunosuppression were significantly higher among HIV-infected individuals with anemia (40.00% and 17.14%) than those without anemia (21.00% and 9.33%) (χ2 = 10.37 and 8.79, both P values < 0.01). Univariate analysis showed a higher detection rate of anemia among female HIV-infected individuals than among males [odds ratio (OR) = 4.528, 95% confidence interval (CI): (3.811, 5.245), P < 0.001], a higher rate among HIV-infected individuals at ages of 45 to < 60 years [OR = 3.415, 95% CI: (1.191, 9.788), P = 0.022] and 60 years and older [OR = 5.820, 95% CI: (2.013, 16.826), P < 0.001] than among those at ages of 15 to < 30 years, a higher rate among HIV-infected individuals through heterosexual transmission than among those through homogeneous transmission [OR = 3.015, 95% CI: (1.423, 6.387), P = 0.004], a lower rate among HIV-infected individuals with an educational level of college and above than among those with an educational level of primary school [OR = 0.103, 95% CI: (0.028, 0.386), P < 0.001], a higher rate among HIV-infected individuals with baseline CD4 cell counts of < 200 cells/μL than among those with baseline CD4 cell counts of 200 cells/μL and higher [OR = 4.340, 95% CI: (2.165, 8.702), P < 0.001], and lower detection rates among HIV-infected individuals with CD4/CD8 cell ratios of 0.208 to < 0.326 [OR = 0.232, 95% CI: (0.076, 0.711), P = 0.011] and 0.516 and higher [OR = 0.292, 95% CI: (0.104, 0.818), P = 0.019] than among those with CD4/CD8 cell ratios of < 0.208. Multivariate logistic regression analysis identified woman [OR = 4.945, 95% CI: (3.944, 5.946), P = 0.002], and CD4 cell counts of < 200 cells/μL [OR = 3.597, 95% CI: (1.448, 8.937), P = 0.006] as risk factors of anemia among newly reported HIV/AIDS patients.Conclusions: The incidence of anemia was low among newly reported HIV/AIDS patients in Jiangsu Province in 2021, and the immune status was poorer among HIV-infected individuals with anemia than those without anemia at baseline and one year following ART. Female and CD4 cell counts of < 200 cells/μL are risk factors of anemia among individuals living with HIV infections, and intensified surveillance, follow-up and precision interventions are recommended targeting female HIV-infected individuals and HIV-infected individuals with low CD4 cell counts.","PeriodicalId":38874,"journal":{"name":"中国血吸虫病防治杂志","volume":"36 6","pages":"598-605"},"PeriodicalIF":0.0000,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Incidence and risk factors of anemia among newly reported HIV/AIDS patients in Jiangsu Province in 2021].\",\"authors\":\"Z Zhang, Q Sun, T Qiu, P Ding, B Wang, B Zhu\",\"doi\":\"10.16250/j.32.1915.2024174\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objective: To investigate the incidence of anemia and evaluate the immune status among newly reported HIV/AIDS patients in Jiangsu Province in 2021, and to identify the risk factors of anemia among patients living with HIV infections.Methods: Newly reported HIV/AIDS patients in Jiangsu Province from January 1 to December 31, 2021 that were registered in China's National AIDS Comprehensive Control Information Management System were enrolled. Subjects' fresh whole blood samples were collected, and hemoglobin levels, CD4 and CD8 cell counts and HIV viral loads were measured. Anemia was defined according to hemoglobin levels, and the immunological parameters and HIV viral loads were compared between HIV-infected patients with and without anemia. The risk factors of anemia were identified among individuals living with HIV infections using univariate analysis and multivariate logistic regression analysis. In addition, subjects' CD4 cell counts one year following antiretroviral therapy (ART) were retrieved from China's National AIDS Comprehensive Control Information Management System, and compared between subjects with and without anemia.Results: A total of 635 newly diagnosed HIV/AIDS patients were reported in Jiangsu Province in 2021, including 544 males (85.67%) and 91 females (14.33%), and with ages of 15 to 83 years, and the overall incidence of anemia was 5.51% (35/635) among the study subjects. 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The median CD4 cell counts remained lower among HIV-infected individuals with anemia than those without anemia [296 (interquartile range, 229) cells/μL vs. 457 (interquartile range, 313) cells/μL; Z = -3.71, P < 0.05] one year following ART, and the proportions of moderate and severe immunosuppression were significantly higher among HIV-infected individuals with anemia (40.00% and 17.14%) than those without anemia (21.00% and 9.33%) (χ2 = 10.37 and 8.79, both P values < 0.01). Univariate analysis showed a higher detection rate of anemia among female HIV-infected individuals than among males [odds ratio (OR) = 4.528, 95% confidence interval (CI): (3.811, 5.245), P < 0.001], a higher rate among HIV-infected individuals at ages of 45 to < 60 years [OR = 3.415, 95% CI: (1.191, 9.788), P = 0.022] and 60 years and older [OR = 5.820, 95% CI: (2.013, 16.826), P < 0.001] than among those at ages of 15 to < 30 years, a higher rate among HIV-infected individuals through heterosexual transmission than among those through homogeneous transmission [OR = 3.015, 95% CI: (1.423, 6.387), P = 0.004], a lower rate among HIV-infected individuals with an educational level of college and above than among those with an educational level of primary school [OR = 0.103, 95% CI: (0.028, 0.386), P < 0.001], a higher rate among HIV-infected individuals with baseline CD4 cell counts of < 200 cells/μL than among those with baseline CD4 cell counts of 200 cells/μL and higher [OR = 4.340, 95% CI: (2.165, 8.702), P < 0.001], and lower detection rates among HIV-infected individuals with CD4/CD8 cell ratios of 0.208 to < 0.326 [OR = 0.232, 95% CI: (0.076, 0.711), P = 0.011] and 0.516 and higher [OR = 0.292, 95% CI: (0.104, 0.818), P = 0.019] than among those with CD4/CD8 cell ratios of < 0.208. 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引用次数: 0

摘要

目的：了解江苏省2021年新报告HIV/AIDS患者贫血发生率及免疫状况，探讨HIV感染患者贫血的危险因素。方法：选取江苏省2021年1月1日至12月31日在中国艾滋病综合防治信息管理系统中登记的新报告艾滋病患者。采集受试者新鲜全血样本，测定血红蛋白水平、CD4和CD8细胞计数及HIV病毒载量。根据血红蛋白水平定义贫血，并比较有和无贫血的HIV感染者的免疫参数和HIV病毒载量。通过单因素分析和多因素logistic回归分析，确定HIV感染者贫血的危险因素。此外，从中国国家艾滋病综合控制信息管理系统中检索受试者在抗逆转录病毒治疗（ART）后一年的CD4细胞计数，并将有无贫血的受试者进行比较。结果：2021年江苏省共报告新诊断HIV/AIDS患者635例，其中男性544例（85.67%），女性91例（14.33%），年龄在15 ~ 83岁之间，研究对象贫血总体发生率为5.51%（35/635）。男性、45岁及以下的个体和工人的血红蛋白水平相对较高，血红蛋白水平的中位数分别为156（四分位数范围22）、154（四分位数范围23）和162（四分位数范围19）g/L。HIV-贫血感染者的基线HIV病毒载量中位数为40 500.00（四分位数范围，119 735.00）copies/mL，非贫血感染者的基线HIV病毒载量中位数为29 754.00 (69 183.00)copies/mL (Z = -0.91, P = 0.31)，且HIV-贫血感染者的CD4和CD8细胞计数中位数[166（四分位数范围，143）cells/μL和755 (653)cells/μL]显著低于非贫血感染者[308 (253)cells/μL和892 (638)cells/μL] （Z = -4.36和-2.37）。P值均< 0.05)。艾滋病毒感染的贫血患者CD4细胞计数中位数仍低于无贫血患者[296（四分位数范围，229）个细胞/μL vs. 457（四分位数范围，313）个细胞/μL；Z = -3.71, P < 0.05]，贫血hiv感染者出现中度和重度免疫抑制的比例（40.00%和17.14%）显著高于无贫血hiv感染者（21.00%和9.33%）（χ2 = 10.37、8.79，P值均< 0.01）。单因素分析显示，女性hiv感染者的贫血检出率高于男性[比值比(OR) = 4.528, 95%可信区间（CI）：（3.811, 5.245）， P < 0.001]， 45 ~ 60岁hiv感染者的贫血检出率高于男性[OR = 3.415, 95% CI: (1.191, 9.788), P = 0.022]和60岁及以上hiv感染者[OR = 5.820, 95% CI：（2.013, 16.826）， P < 0.001)与15 ~ 30岁以下人群相比，异性恋传播的hiv感染者感染率高于同质传播的hiv感染者[OR = 3.015, 95% CI: (1.423, 6.387), P = 0.004]，大学及以上文化程度的hiv感染者感染率低于小学文化程度的hiv感染者[OR = 0.103, 95% CI：（0.028, 0.386）， P < 0.001)，基线CD4细胞计数< 200细胞/μL的hiv感染者检出率高于基线CD4细胞计数≥200细胞/μL的hiv感染者[OR = 4.340, 95% CI: (2.165, 8.702), P < 0.001]， CD4/CD8细胞比值为0.208 ~ < 0.326 [OR = 0.232, 95% CI: (0.076, 0.711), P = 0.011]和0.516及以上的hiv感染者检出率较低[OR = 0.292, 95% CI：（0.104, 0.818）， P = 0.019)高于CD4/CD8细胞比值< 0.208的患者。多因素logistic回归分析发现，女性[OR = 4.945, 95% CI: (3.944, 5.946), P = 0.002]和CD4细胞计数< 200 cells/μL [OR = 3.597, 95% CI: (1.448, 8.937), P = 0.006]是新报告HIV/AIDS患者贫血的危险因素。结论：江苏省2021年新报告的HIV/AIDS患者中贫血发生率较低，且HIV感染者在基线和抗逆转录病毒治疗后1年的免疫状况较无贫血者差。女性和CD4细胞计数< 200 cells/μL是HIV感染者贫血的危险因素，建议针对女性HIV感染者和CD4细胞计数低的HIV感染者加强监测、随访和精准干预。

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[Incidence and risk factors of anemia among newly reported HIV/AIDS patients in Jiangsu Province in 2021].

Objective: To investigate the incidence of anemia and evaluate the immune status among newly reported HIV/AIDS patients in Jiangsu Province in 2021, and to identify the risk factors of anemia among patients living with HIV infections.

Methods: Newly reported HIV/AIDS patients in Jiangsu Province from January 1 to December 31, 2021 that were registered in China's National AIDS Comprehensive Control Information Management System were enrolled. Subjects' fresh whole blood samples were collected, and hemoglobin levels, CD4 and CD8 cell counts and HIV viral loads were measured. Anemia was defined according to hemoglobin levels, and the immunological parameters and HIV viral loads were compared between HIV-infected patients with and without anemia. The risk factors of anemia were identified among individuals living with HIV infections using univariate analysis and multivariate logistic regression analysis. In addition, subjects' CD4 cell counts one year following antiretroviral therapy (ART) were retrieved from China's National AIDS Comprehensive Control Information Management System, and compared between subjects with and without anemia.

Results: A total of 635 newly diagnosed HIV/AIDS patients were reported in Jiangsu Province in 2021, including 544 males (85.67%) and 91 females (14.33%), and with ages of 15 to 83 years, and the overall incidence of anemia was 5.51% (35/635) among the study subjects. Men, individuals at ages of 45 years and lower and workers had relatively higher hemoglobin levels, with median hemoglobin levels of 156 (interquartile range, 22), 154 (interquartile range, 23) g/L and 162 (interquartile range, 19) g/L, respectively. The median baseline HIV viral load was 40 500.00 (interquartile range, 119 735.00) copies/mL among HIV-infected individuals with anemia and 29 754.00 (69 183.00) copies/mL among those without anemia (Z = -0.91, P = 0.31), and the median baseline CD4 and CD8 cell counts were significantly lower among HIV-infected individuals with anemia [166 (interquartile range, 143) cells/μL and 755 (653) cells/μL] than those without anemia [308 (253) cells/μL and 892 (638) cells/μL] (Z = -4.36 and -2.37, both P values < 0.05). The median CD4 cell counts remained lower among HIV-infected individuals with anemia than those without anemia [296 (interquartile range, 229) cells/μL vs. 457 (interquartile range, 313) cells/μL; Z = -3.71, P < 0.05] one year following ART, and the proportions of moderate and severe immunosuppression were significantly higher among HIV-infected individuals with anemia (40.00% and 17.14%) than those without anemia (21.00% and 9.33%) (χ² = 10.37 and 8.79, both P values < 0.01). Univariate analysis showed a higher detection rate of anemia among female HIV-infected individuals than among males [odds ratio (OR) = 4.528, 95% confidence interval (CI): (3.811, 5.245), P < 0.001], a higher rate among HIV-infected individuals at ages of 45 to < 60 years [OR = 3.415, 95% CI: (1.191, 9.788), P = 0.022] and 60 years and older [OR = 5.820, 95% CI: (2.013, 16.826), P < 0.001] than among those at ages of 15 to < 30 years, a higher rate among HIV-infected individuals through heterosexual transmission than among those through homogeneous transmission [OR = 3.015, 95% CI: (1.423, 6.387), P = 0.004], a lower rate among HIV-infected individuals with an educational level of college and above than among those with an educational level of primary school [OR = 0.103, 95% CI: (0.028, 0.386), P < 0.001], a higher rate among HIV-infected individuals with baseline CD4 cell counts of < 200 cells/μL than among those with baseline CD4 cell counts of 200 cells/μL and higher [OR = 4.340, 95% CI: (2.165, 8.702), P < 0.001], and lower detection rates among HIV-infected individuals with CD4/CD8 cell ratios of 0.208 to < 0.326 [OR = 0.232, 95% CI: (0.076, 0.711), P = 0.011] and 0.516 and higher [OR = 0.292, 95% CI: (0.104, 0.818), P = 0.019] than among those with CD4/CD8 cell ratios of < 0.208. Multivariate logistic regression analysis identified woman [OR = 4.945, 95% CI: (3.944, 5.946), P = 0.002], and CD4 cell counts of < 200 cells/μL [OR = 3.597, 95% CI: (1.448, 8.937), P = 0.006] as risk factors of anemia among newly reported HIV/AIDS patients.

Conclusions: The incidence of anemia was low among newly reported HIV/AIDS patients in Jiangsu Province in 2021, and the immune status was poorer among HIV-infected individuals with anemia than those without anemia at baseline and one year following ART. Female and CD4 cell counts of < 200 cells/μL are risk factors of anemia among individuals living with HIV infections, and intensified surveillance, follow-up and precision interventions are recommended targeting female HIV-infected individuals and HIV-infected individuals with low CD4 cell counts.

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来源期刊

中国血吸虫病防治杂志 Medicine-Medicine (all)

CiteScore

1.30

自引率

0.00%

发文量

7021

期刊介绍： Chinese Journal of Schistosomiasis Control (ISSN: 1005-6661, CN: 32-1374/R), founded in 1989, is a technical and scientific journal under the supervision of Jiangsu Provincial Health Commission and organised by Jiangsu Institute of Schistosomiasis Control. It is a scientific and technical journal under the supervision of Jiangsu Provincial Health Commission and sponsored by Jiangsu Institute of Schistosomiasis Prevention and Control. The journal carries out the policy of prevention-oriented, control-oriented, nationwide and grassroots, adheres to the tenet of scientific research service for the prevention and treatment of schistosomiasis and other parasitic diseases, and mainly publishes academic papers reflecting the latest achievements and dynamics of prevention and treatment of schistosomiasis and other parasitic diseases, scientific research and management, etc. The main columns are Guest Contributions, Experts‘ Commentary, Experts’ Perspectives, Experts' Forums, Theses, Prevention and Treatment Research, Experimental Research, The main columns include Guest Contributions, Expert Commentaries, Expert Perspectives, Expert Forums, Treatises, Prevention and Control Studies, Experimental Studies, Clinical Studies, Prevention and Control Experiences, Prevention and Control Management, Reviews, Case Reports, and Information, etc. The journal is a useful reference material for the professional and technical personnel of schistosomiasis and parasitic disease prevention and control research, management workers, and teachers and students of medical schools. 　　 The journal is now included in important domestic databases, such as Chinese Core List (8th edition), China Science Citation Database (Core Edition), China Science and Technology Core Journals (Statistical Source Journals), and is also included in MEDLINE/PubMed, Scopus, EBSCO, Chemical Abstract, Embase, Zoological Record, JSTChina, Ulrichsweb, Western Pacific Region Index Medicus, CABI and other international authoritative databases.