The Analysis Of Epidemiological Characteristics Of HIV/AIDS Cases Reported In Wuhan From 2016 To 2019

Objectives:To describe the distribution,epidemiological characteristics and baseline clinical characteristics of HIV/AIDS in Wuhan from 2016 to 2019,and to analyze the influencing factors of death.Methods:The information of HIV/AIDS patients reported in Wuhan from January 1,2016to December 31,2019 was derived from the“HIV/AIDS comprehensive prevention and control information system”.The distribution of HIV/AIDS patients and the symptoms,signs,opportunistic infections,comorbidities of patients were described and analyzed.The influencing factors of death were analyzed by using univariate and multivariate unconditional logistic regression.Results:1.The majority of the HIV/AIDS patients reported in Wuhan from January 1,2016to December 31,2019 were male（90.18%）,unmarried people（54.05%）accounted for more than half,the living area was mainly in the central urban area（65.32%）,and the majority of household registration was in Wuhan（94.84%）;The reported cases were mainly young and middle-aged,of which the age range was 26-35 years old,accounting for 33.30%;The deceased were older,and those over 55 years old accounted for 62.65%;At the time of diagnosis,most patients had reached WHO level II,with 1473 cases,accounting for 51.23%;There were only 484 spouses of reported cases were tested for HIV,and more than half of them were positive（51.65%）;At present,2749 cases are undergoing antiviral treatment,accounting for 95.06%;only 19.36%of reported cases knew their infection status through passive HIV testing;The proportion of cases with a history of MSM and non-marital heterosexual contact were 64.49%and 34.61%,respectively,and a small number of cases（3.67%）had multiple high-risk behaviors.2.The infection route of HIV/AIDS patients reported in Wuhan was mainly sexual transmission,and the proportion of homosexual transmission was greater than heterosexual transmission（64.32%vs 35.24%）,different genders（?²=570.63,P<0.001）,age（?²=553.28,P<0.001）,marital status（?²=696.40,P<0.001）of reported cases had different routes of sexual transmission.3.The reported cases with a baseline CD₄⁺T cell count of 200-350/mm³ cells accounted for the largest proportion（32.68%）,and with a baseline viral load of 5000 to100000IU/ml accounted for the most（56.52%）,As the amount of virus increases,the number of CD₄⁺T cells tends to decrease（non-parametric Jonckheere-Terpstra test,P<0.001）.4.39.18%of the reported cases developed disease symptoms and signs.Common symptoms and signs were cough,fever,night sweats,diarrhea,enlarged lymph nodes,rash and expectoration.The highest incidence rate of symptoms and signs was cough（13.90%）,followed by fever（10.55%）.5.9.54%of the reported cases had viral hepatitis,and the incidence of opportunistic infections was 25.66%.The main sites of opportunistic infections were skin,oral cavity,and lungs.6.The initial treatment plan and the most recent treatment plan for reported cases were mainly the first-line treatment plan of“3TC+TDF+EFV”（69.81%and 65.96%,respectively）,followed by“3TC+AZT+EFV”（17.67%and 13.58%,respectively）.Compared with the initial treatment plan,the proportion of second-line drug use has increased（from 1.48%to 6.26%）in the most recent treatment plan.7.Univariate logistic regression analysis showed marital status,age at diagnosis,WHO stage,transmission route,baseline CD₄⁺T cell number,baseline viral load,white blood cell number,platelet number,hemoglobin content,total cholesterol,fasting blood glucose,blood creatinine,and suffering from thrush,severe recurrent bacterial infections,severe recurrent bacterial pneumonia,pneumocystis pneumonia,and other opportunistic infections/tumors were factors that affected the death of HIV/AIDS patients.Multivariate logistic regression analysis showed that the age,white blood cell number,hemoglobin content,suffering from severe recurrent bacterial pneumonia or other opportunistic infections/tumors were factors that had impact on the death of HIV/AIDS patients.Conclusions:The reported HIV/AIDS patients in Wuhan from 2016 to 2019 were mostly young and middle-aged male,unmarried,living in central urban areas,and household registration was Wuhan.and the deceased were older.The main routine of infection was sexual transmission,a small number of cases were informed of their own infection status through passive inspection.At the time of diagnosis,most patients had reached WHO level II or above,when there are many symptoms and signs,with high rates of complications and opportunistic infections,and death of patients was related to various factors.In the process of preventing and controlling AIDS epidemic in the future,we must focus on unmarried men,while adolescents and elderly people cannot be ignored.AIDS should be detected early,diagnosed early,pay close attention to complications,and give treat symptomatically to reduce the adverse outcomes.