Duration of Human Immunodeficiency Virus Infection at Diagnosis among New Human Immunodeficiency Virus Cases in Dehong, Yunnan, China, 2008–2015

: 云南省德宏州2008-2015年新报告的HIV感染者从感染至诊断发现的时间分析摘要目的：HIV感染者在被诊断发现时可能已经感染多年了。本研究的目的是估计HIV感染者在被诊断发现时的感染时间。 方法：研究对象为中国德宏州2008至2015年新诊断报告的HIV病例。诊断发现时的感染时间是依据CD4数值与感染时间的衰减模型，利用感染者首次CD4检测值反推计算获得的。使用多重线性回归模型分析影响诊断时感染时间的危险因素。 结果：研究共纳入5867例新诊断发现的HIV病例。研究对象诊断时的感染时间均值为6.3年（95%可信区间：6.2~6.5）。多重线性回归模型结果显示，在被诊断发现时，女性的感染时间显著短于男性（回归系数: -0.37；95%可信区间: -0.64~-0.09）,傣族的感染时间显著短于汉族、景颇族和其它民族（回归系数: -0.28；95%可信区间：-0.57~0.01），经注射吸毒感染的人群其感染时间显著短于性传播感染人群（回归系数: -1.82；95%可信区间：-2.25~-1.39）。相较其他来源的感染者，医院来源的感染者其感染时间更久。相较2008年新诊断发现的感染者，自2010年后新诊断发现的感染者其感染时间更短。 结论：德宏州HIV感染者在被诊断发现时的感染时间呈明显缩短趋势，但其影响不大。. Methods: Newly diagnosed HIV cases in Dehong, China, from 2008 to 2015 were studied. Duration of infection at the time of diagnosis was calculated using the first CD4 cell count result after diagnosis and a CD4 depletion model of disease progression. Multiple linear regression analysis was used to investigate the associated risk factors. Results: A. : total of 5867 new HIV cases were enrolled. Overall, mean duration of infection was 6.3 years (95% confidence interval [CI]: 6.2, 6.5). After adjusting for confounding, significantly shorter durations of infection were observed among participants who were female (beta: -0.37, 95% CI: -0.64, -0.09), Dai ethnicity (beta: -0.28, 95% CI: -0.57, 0.01), and infected through injecting drug use (beta: -1.82, 95% CI: -2.25, -1.39). Compared to the hospital setting, durations were shorter for those diagnosed in any other settings, and compared to 2008, durations were shorter for those diagnosed all years after 2010. Conclusion: Although the reduction in duration of infection at the time of diagnosis observed in Dehong was significant, it may not have had a meaningful impact.