武汉市2013-2024年新报告50岁及以上HIV/AIDS病例特征变化趋势分析

Epidemiological characteristics and trends of newly reported aged 50 years and above HIV/AIDS cases in Wuhan , 2013-2024

  • 摘要:
    目的 分析2013~2024年武汉市新报告≥50岁HIV/AIDS流行特征及变化趋势,为艾滋病防控提供依据。
    方法 通过全民健康保障信息化工程中国疾病预防控制信息系统下载2013—2024年武汉市新报告≥50岁HIV/AIDS 数据信息,描述不同年份HIV/AIDS的分布特征,使用Joinpoint回归模型分析其变化趋势。
    结果 2013~2024年武汉市新报告≥50岁HIV/AIDS 2515例。男女性别比4.44:1,诊断时年龄中位数为59岁,性传播病例占99.01%;病例样本来源以医疗机构检测发现为主,占75.47%。2013-2024 年武汉市≥50岁HIV/AIDS 新发现率总体变化趋势差异无统计学意义,其中2013-2017 年上升较快(APC=18.71%,P<0.001),2017年后呈逐年缓慢下降趋势(APC=−7.58%,P<0.001)。男性新发现率高于女性,在2013-2017年上升较快(APC=16.52%,P<0.001),2017-2024年呈下降趋势(APC=−8.47%,P=0.007);女性新发现率新发现率总体呈上升趋势(APC=12.90%,P<0.001)。60~69岁年龄组HIV/AIDS新发现率总体呈上升趋势(APC=7.45%,P<0.001)。现住址为中心城区的≥50岁HIV/AIDS新发现率在2013-2017年上升趋势(APC=16.56%,P<0.001),2017年后呈下降趋势(APC=−6.62%,P=0.001);远城区在2013-2017年上升较快(APC=30.04%,P<0.001),2017年后变化趋势差异无统计学意义。首次CD4+T淋巴细胞计数<200/μL的病例构成比呈现单调上升趋势(APC=2.88%,P<0.001),首次CD4+T淋巴细胞计数为350~499/μL(APC=−4.13%,P=0.011)、≥500/μL(APC=−9.09%,P=0.013)的病例构成比均呈现下降趋势。
    结论 2013-2024年武汉市≥50岁HIV/新发现率总体平稳,但是男性、60-69岁年龄组人群疫情形势仍不容乐观,病例总体发现较晚。需根据人群特点和疫情特征出发AIDS针对性制定宣教和防控策略,有效遏制艾滋病传播。

     

    Abstract:
    Objective To understand the epidemiological characteristics and trends of newly reported aged 50 years and above human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) cases in Wuhan city during 2013-2024 and provide theoretical evidence for the prevention and control of AIDS.
    Methods The information of newly reported aged 50 years and above HIV/AIDS cases in Wuhan from 2013 to 2024 were downloaded from the National Health Security and Disease Control Information System, and the characteristics of the newly reported aged 50 years and above HIV/AIDS cases were statistically described and analyzed, and the trends were analyzed by using Joinpoint regression model.
    Results A total of 2515 new 50 years and above HIV/AIDS cases were reported in Wuhan from 2013 to 2024, The cases were mainly caused by sexual transmission, the male to female ratio of the cases was 4.44: 1, and the median age of the cases was 59 years and the cases caused by sexual transmission accounted for 99.01%. The cases were mainly reported by medical institutions, accounting for 75.47%.The trend analysis showed that the overall diagnosis rate showed no significant change among newly reported aged 50 years and above cases in Wuhan from 2013 to 2024.An increasing trend from 2013 to 2017 annual percentage changes (APC)=18.71%, P<0.001, and slowly decreased from 2017 to 2024(APC=−7.58%, P<0.001). The diagnosis rates in men is higher than women, an increasing trend from 2013 to 2017(APC=16.52%, P<0.001),and slowly decreased from 2017 to 2024(APC=−8.47%,P=0.007). The diagnosis rate in women showed an increasing trend from 2013 to 2024(APC=12.90%, P<0.001).The diagnosis rate showed an increasing trend in age group 60-69 years (APC=7.45%, P=0.029). The diagnosis rates in urban area was similar to the overall rate,the diagnosis rates showed a rapid increasing trend in suburb from 2013 to 2017 (APC=30.04%,P<0.001) and the change after 2017 was not significant. The proportion of newly reported HIV/AIDS cases with the first CD4+T count <200/μL showed an increasing trend (APC=2.88%,P<0.001), but the proportion of newly reported HIV/AIDS cases with the first CD4+T count 350-499/ μL (APC=−4.13%,P=0.001), ≥500/μL (APC=−9.09%, P=0.0132)showed decreasing trends.
    Conclusion From 2013 to 2024,no significant trend change of the overall diagnosis rate was showed among newly reported aged 50 years and above HIV/AIDS cases in Wuhan. But male, in urban area in Wuhan and 60-69 age group still showed decrease. It is suggested to pay close attention to the elderly group, more efforts should be made to improve active surveillance and more precise intervention measures should be take to effectively prevent and control HIV /AIDS infection among this population.

     

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