Analysis On The Efficacy Of Antiviral Therapy For MSM Patients With HIV/AIDS For 3 Years

Objective:By observing the efficacy of antiviral therapy for MSM patients with HIV/AIDS for 3 years and analyzing the influencing factors,it provides a reference for the development of individualized treatment plans and improves the antiviral therapy of efficacy for MSM patients with HIV/AIDS.Methods:Through the National AIDS Comprehensive Prevention and Control Information System,collected the HIV/AIDS patients in Zhuhai City from January 1,2008to December 31,2017 who met the inclusion and exclusion criteria for retrospective acohort study,and collected cases with treatment time of≥36 months 536 cases were divided into observation group and control group,there were 309 cases in observation group(MSM patients with HIV/AIDS)and 227 cases in control group(non-MSM patients with HIV/AIDS).The sociodemographic characteristic,the baseline of CD4~+T cell counts,opportunistic infections before ART,the number of sexual partners,the time from diagnosis to start of ART,missed doses,drug withdrawal and deaths within 3 years of antiviral therapy,and CD4~+T cell counts,CD8~+T cell counts after antiviral therapy every 6months,HIV viral load every 12 months,etc.The data was tested for normal distribution and homogeneity of variance,repeated measures of variance analysis was used to observe the immunological efficacy of the observation group and the control group before and after treatment,and the Chi-square test was used for two group after 12,24,and 36 months after antiviral treatment Virology curative effect analysis.At the same time,single factor analysis was used to screen the relevant factors that may affect the antiviral efficacy,and the selected possible related factors were included in the multivariate logistic regression analysis(test level a=0.05).Result:1.Baseline characteristics:The average age at baseline of the 309 MSM patients with HIV/AIDS was 33.25±9.31 years old,66.0%of the patients were unmarried,and70.6%of them had a high school education or above.The household registration is mainly foreign household registration,accounting for 58.3%.The time from diagnosis to the start of ART was less than 1 month in 71.2%of patients,77%of patients with WHO clinical staging were stage I and II,69.0%of patients with baseline CD4~+T cell counts≥200cells/mm~3.Compared with non-MSM patients with HIV/AIDS,there were differences in baseline CD4~+T cell counts,WHO clinical staging,and the time from diagnosis to the start of ART(P<0.05).There were no statistically significant differences in baseline age,marital status,hometown,educational background,and initial antiviral treatment regimen(P>0.05).2.The CD4~+T cell counts and CD4~+/CD8~+ratios showed different degrees of increase for MSM patients with HIV/AIDS and non-MSM patients after antiviral treatment 6,12,18,24,30,36 months.The growth rate was the fastest within 6 months,slowed down after 12months,and increased after 24 months slowly.The CD4~+T cell counts and CD4~+/CD8~+ratio of MSM patients with HIV/AIDS were greater than those of non-MSM patients with HIV/AIDS after 36 months,P<0.05,the difference was significant statistically.Both groups of patients’CD8~+T cell counts showed a downward trend after 6 months of antiviral treatment,and remained at a certain level after 24 months,with no obvious fluctuations.The percentage of the two groups of patients with CD4~+/CD8~+ratio≥1 gradually increased after ART.Among them,the proportion of MSM patients with HIV/AIDS after receiving treatment for 12 months were higher than non-MSM patients with HIV/AIDS,and the difference was statistically significant(P<0.05).3.The virus inhibition rates were 98.1%(303/309),96.8%(299/309),and 98.4%(304/309)in MSM patients with HIV/AIDS after receiving treatment 12 months,24 months,and 36months.The rates of non-MSM patients with HIV/AIDS at 12 months,24 months,and 36months were 93.8%(213/227),91.6%(208/227),92.5%(210/227),respectively.The virus inhibition rate of the patients in two groups were all>90%,and the rates in MSM patients with HIV/AIDS were better than non-MSM patients after antiviral treatment(P<0.05),the difference was statistically significant.4.Multivariate logistic regression analysis showed that baseline age,hepatitis,number of sexual partners,and changing antiviral regimens during the antiviral treatment among MSM patients with HIV/AIDS did not have a significant impact on the efficacy(P>0.05).Factors affecting the efficacy of antiviral treatment include the time of antiviral treatment,baseline CD4~+T cell counts,combined opportunistic infections,and the level of education(P<0.05).Among them,The risk of failure antiviral efficacy include from diagnosis to ART with an interval≥1 month is 2.276 times that of<1 month(95%CI:1.027-5.047),and the baseline CD4~+T cell count<200 cells/mm~3were≥200 cells/mm~30.339times(95%CI:0.126-0.909),opportunistic infections before treatment with opportunistic infections was 4.824 times(95%CI:1.567-14.850)than that without opportunistic infections,lower education was a risk factor for antiviral efficacy(OR:0.377,95%CI:0.15-0.949).Conclusion:1.The immune function of MSM patients with HIV/AIDS was improved after antiviral treatment,the virus suppression rate was significantly.2.The efficacy of antiviral therapy was effected for MSM patients with HIV/AIDS by lower baseline CD4~+T cell counts,failure to receive antiviral therapy in time,combined with opportunistic infections,and lower level of education from different degrees.