基于患者医疗需求的艾滋病抗病毒治疗模式探索与实践

摘要

Objective To explore and evaluate the model of antiretroviral treatment that oriented to the medical needs of people living with HIV/AIDS (HIV/AIDS),based on the local prevalence of HIV/AIDS.Methods A total of 268 HIV/AIDS were selected the CDC of 13 administrative district in Wuhan from 2012 to 2013 and 275 HIV/AIDS were selected in the hospitals of 13 administrative district in Wuhan from 2013 to 2014.The antiretroviral effect of the two groups was compared and the related factors were analyzed.Results An antiretroviral treatment network that oriented to the medical needs of HIV/AIDS was developed.Data showed that the adherence of patients was better than that when the treatment was carried out at the CDC offices and the status of immuno-recovery on HIV/AIDS was more effective than the hospital-based treatment (P＜0.05).Data from multivariable logistic regression analysis showed that different patterns did play different roles on the effects of treatment.Conclusions The mode of antiretroviral treatment that oriented to the medical needs of HIV/AIDS could effectively improve the adherence and outcomes of treatment.We believe this model could also be adopted elsewhere.%目的 探索和评价基于患者医疗需求的艾滋病抗病毒治疗模式.方法 收集2012-2013年武汉市13个区级CDC治疗的268例艾滋病病毒感染者和艾滋病患者(HIV/AIDS)及2013-2014年13个区级定点医院治疗的275例HIV/AIDS,比较两者抗病毒治疗效果,并分析相关影响因素.结果 武汉市基于患者医疗需求的、由医疗机构临床医师提供的“一站式”抗病毒治疗模式及服务体系建成.该模式入组患者抗病毒治疗依从性、治疗6～12个月免疫恢复率以及治疗12个月存活并坚持治疗率均优于由CDC公共卫生医师提供的抗病毒治疗模式,差异有统计学意义(P＜0.05).多因素logistic回归分析结果显示,治疗模式是影响患者治疗效果的影响因素之一.结论 基于患者医疗需求的抗病毒治疗模式能有效提高患者治疗依从性和治疗效果,为本地区艾滋病抗病毒治疗工作长期可持续性发展打下坚实基础,也可为其他地区相关工作开展提供借鉴.