Influenza vaccination and seroepidemiological status in elderly HIV-infected patients in Taizhou, Zhejiang Province
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摘要:
目的 对浙江省台州市2018―2019年老年HIV感染者流感疫苗接种特征及流感抗体阳性率进行分析。 方法 运用描述性流行病学方法,分析老年HIV感染者接种流感疫苗现状及接种疫苗后抗体水平,并应用Logistic回归分析模型进行影响因素分析。 结果 本研究共纳入台州市≥60岁HIV感染者749人,2018―2019年流感疫苗接种率为33.9%,其中2018年和2019年流感疫苗接种率分别为22.3%和23.6%,持续接种率为12.0%。老年HIV感染者的流感疫苗接种率在不同职业中差异有统计学意义(P < 0.001)。浙江省台州市老年HIV感染者年龄70~80岁(OR=1.84; 95% CI: 1.32~2.58)、职业为农民(OR=3.89; 95% CI: 1.69~8.98)是疫苗接种的影响因素。本研究老年HIV感染者的流感抗免疫球蛋白G(immunoglobulin G, IgG)的血清阳性率分别为21.2%(甲型H1N1流感)、18.1%(甲型H3N2流感)、8.8%(乙型流感)。 结论 浙江省台州市老年HIV感染者流感疫苗接种率与其年龄和职业存在关联,疫苗接种效果评价仍需要更多证据的支持。 Abstract:Objective To elucidate the characteristics and influencing factors of influenza vaccination among elderly people infected with HIV and the positive rate of influenza antibodies from 2018 to 2019. Methods Epidemiological methods of description were used to analyze the current status of influenza vaccination and post-vaccination antibody levels in elderly HIV-infected patients, and Logistic regression models were applied to analyze the influencing factors. Results A total of 749 HIV-infected people over 60 years old in Taizhou were included in this study. The influenza vaccination rate from 2018 to 2019 was 33.9%, of which the vaccination rate in 2018 and 2019 was 22.3% and 23.6%, respectively, and the continuous vaccination rate was 12.0%. There were differences in age, occupation and education level among the elderly HIV-infected people with different vaccination choices. Age 70-80 years old (OR=1.84; 95% CI: 1.32-2.58), farmer (OR=3.89; 95% CI: 1.69-8.98) were factors influencing vaccination rates. In addition, the serological positive rates of influenza antibody immunoglobulin G (IgG) in elderly HIV-infected patients were 21.2% (Influenza A H1N1), 18.1% (Influenza A H3N2) and 8.8% (Influenza B). Conclusions Influenza vaccination rates among elderly HIV-infected patients in Taizhou, Zhejiang Province, were significantly associated with their age and occupation. More evidence is needed to evaluate the efficacy of vaccination. -
表 1 2018―2019年台州市老年HIV感染者流感疫苗接种情况[n(%)]
Table 1. Influenza vaccination in the elderly infected with HIV in Taizhou from 2018 to 2019 [n(%)]
变量 接种率(%) 合计 接种组 未接种组 年龄(岁) 60~ < 70 28.9 439(58.6) 127(50.0) 312(63.0) 70~ < 80 42.4 257(34.3) 109(42.9) 148(29.9) ≥80 34.0 53(7.1) 18(7.1) 35(7.1) 性别 男 33.5 571(76.2) 191(75.2) 380(76.8) 女 35.4 178(23.8) 63(24.8) 115(23.2) 职业 单位退休人员 15.2 46(6.1) 7(2.8) 39(7.9) 农民 38.9 525(70.1) 204(80.3) 321(64.8) 其他 24.2 178(23.8) 43(16.9) 135(27.3) 文化程度 小学及以下 36.4 552(73.7) 201(79.1) 351(70.9) 初中 29.3 150(20.0) 44(17.3) 106(21.4) 中专及以上 19.1 47(6.3) 9(3.5) 38(7.7) 婚姻 已婚有配偶 36.5 485(64.8) 177(69.7) 308(62.2) 未婚 15.0 20(2.7) 3(1.2) 17(3.4) 离婚或丧偶 30.3 244(32.6) 74(29.1) 170(34.3) 感染途径 异性传播 34.5 658(87.9) 227(89.4) 431(87.1) 同性传播 29.1 79(10.5) 23(9.1) 56(11.3) 血液传播及其他 44.4 12(1.6) 4(1.6) 8(1.6) 性病史 有 33.3 96(12.8) 32(12.6) 64(12.9) 无/不详 36.9 601(80.2) 222(87.4) 431(87.1) CD4+T淋巴细胞水平(个/μl) 0~ < 200 30.8 120(16) 37(14.6) 83(16.8) 200~ < 350 35.3 224(29.9) 79(31.1) 145(29.3) 350~ < 500 31.0 213(28.4) 66(26.0) 147(29.7) ≥500 37.5 192(25.6) 72(28.3) 120(24.2) 表 2 台州市老年HIV感染者疫苗接种影响因素分析
Table 2. Analysis of factors influencing vaccination of elderly HIV-infected patients in Taizhou City
变量 接种率(%) 单因素分析 多因素分析 OR(95% CI)值 P值 OR(95% CI)值 P值 年龄(岁) 60~ < 70 28.9 1.00 70~ < 80 42.4 1.81(1.31~2.5) 0.017 1.84(1.32~2.58) 0.037 ≥80 34.0 1.26(0.69~2.31) 0.835 1.45(0.77~2.73) 0.832 性别 男 33.5 1.00 女 35.4 1.09(0.77~1.55) 0.633 1.13(0.78~1.63) 0.526 职业 单位退休人员 15.2 1.00 农民 38.9 3.54(1.55~8.07) < 0.001 3.89(1.69~8.98) < 0.001 其他 24.2 1.77(0.74~4.26) 0.830 2.10(0.86~5.14) 0.822 文化程度 小学及以下 36.4 1.00 初中 29.3 0.73(0.49~1.07) 0.647 中专及以上 19.1 0.41(0.2~0.87) 0.060 婚姻 已婚有配偶 36.5 1.00 未婚 15.0 0.31(0.09~1.06) 0.099 0.32(0.09~1.14) 0.127 离婚或丧偶 30.3 0.76(0.55~1.05) 0.366 0.74(0.52~1.04) 0.465 感染途径 异性传播 34.5 1.00 同性传播 29.1 0.78(0.47~1.30) 0.574 血液传播及其他 44.4 0.95(0.28~3.19) 0.908 性病史 有 33.3 1.00 无/不详 36.9 1.03(0.65~1.62) 0.898 CD4+T淋巴细胞水平(个/μl) 0~ < 200 30.8 1.00 200~ < 350 35.3 1.22(0.76~1.96) 0.589 350~ < 500 31.0 1.01(0.62~1.63) 0.367 ≥500 37.5 1.35(0.83~2.19) 0.197 表 3 2020年台州市老年HIV感染者随访血清流感抗体IgG阳性率[n(%)]
Table 3. Serum IgG positive rate of influenza antibody in elderly HIV-infected patients in follow-up visits in Taizhou City in 2020 [n(%)]
变量 合计 接种组 未接种组 χ2值 P值 甲型H1N1流感病毒 96(21.2) 35(21.0) 61(21.3) 0.01 0.926 甲型H3N2流感病毒 82(18.1) 34(20.4) 48(16.8) 0.91 0.340 乙型流感病毒 40(8.8) 13(7.8) 27(9.4) 0.36 0.549 -
[1] World Health Organization. 8 Things to know about pandemic influenza[EB/OL]. (2019-03-11)[2021-01-04]. https://www.who.int/news-room/feature-stories/detail/8-things-to-know-about-pandemic-influenza. [2] World Health Organization. Global influenza strategy 2019-2030[EB/OL]. (2019-03-11)[2021-01-04]. https://apps.who.int/iris/handle/10665/311184. [3] 中国疾病预防控制中心. 中国流感疫苗预防接种技术指南(2019—2020)[J]. 中国病毒病杂志, 2019, 9(6): 419-428. DOI: 10.16505/j.2095-0136.2019.0085.Chinese Center for Disease Control and Prevention. Technical guidelines for influenza vaccine vaccination in China (2019-2020)[J]. Chin J Vir Dis, 2019, 9(6): 419-428. DOI: 10.16505/j.2095-0136.2019.0085. [4] Autenrieth CS, Beck EJ, Stelzle D, et al. Global and regional trends of people living with HIV aged 50 and over: estimates and projections for 2000-2020[J]. PLoS One, 2018, 13(11): e0207005. doi: 10.1371/journal.pone.0207005 [5] 台州市卫生和计划生育委员会. 关于印发《台州市艾滋病感染者和病人治疗随访管理实施方案(试行)》的通知[EB/OL]. (2016-03-31)[2021-01-04] http://www.zjtz.gov.cn/art/2016/3/31/art_1229191273_1093798.htmlTaizhou Health and Family Planning Commission Taizhou AIDS patient follow-up management and implementation plan (try out) notice[EB/OL]. (2016-03-31)[2021-01-04]. http://www.zjtz.gov.cn/art/2016/3/31/art_1229191273_1093798.html. [6] Bekkat-Berkani R, Romano-Mazzotti L. Understanding the unique characteristics of seasonal influenza illness to improve vaccine uptake in the US[J]. Vaccine, 2018, 36(48): 7276-7285. DOI: 10.1016/j.vaccine.2018.10.027. [7] Centers for Disease Control and Prevention. Flu vaccination coverage, United States, 2019-2020 influenza season[EB/OL]. (2020-10-01)[2021-01-07]. https://www.cdc.gov/flu/fluvaxview/coverage-1920estimates.htm. [8] Durham MD, Buchacz K, Armon C, et al. Seasonal influenza vaccination rates in the HIV outpatient study-United States, 1999-2013[J]. Clin Infect Dis, 2015, 60(6): 976-977. DOI: 10.1093/cid/ciu979. [9] Wang Q, Yue N, Zheng M, et al. Influenza vaccination coverage of population and the factors influencing influenza vaccination in mainland China: a meta-analysis[J]. Vaccine, 2018, 36(48): 7262-7269. DOI: 10.1016/j.vaccine.2018.10.045. [10] 刘令初, 靳妍, 徐放, 等. 浙江省台州市老年人免费接种流感疫苗覆盖率分析[J]. 疾病监测, 2020, 35(11): 1042-1046. DOI: 10.3784/j.issn.1003-9961.2020.11.017.Liu LC, Jin Y, Xu F, et al. Coverage rate of influenza vaccination in the elderly in Taizhou, Zhejiang[J]. Dis Surveill, 2020, 35(11): 1042-1046. DOI: 10.3784/j.issn.1003-9961.2020.11.017. [11] Wu S, Su J, Yang P, et al. Factors associated with the uptake of seasonal influenza vaccination in older and younger adults: a large, population-based survey in Beijing, China[J]. BMJ Open, 2017, 7(9): e017459. DOI: 10.1136/bmjopen-2017-017459. [12] Larson HJ, Jarrett C, Eckersberger E, et al. Understanding vaccine hesitancy around vaccines and vaccination from a global perspective: a systematic review of published literature, 2007-2012[J]. Vaccine, 2014, 32(19): 2150-2159. DOI: 10.1016/j.vaccine.2014.01.081. [13] Ambrose CS, Levin MJ, Belshe RB. The relative efficacy of trivalent live attenuated and inactivated influenza vaccines in children and adults[J]. Influenza Other Respir Viruses, 2011, 5(2): 67-75. DOI: 10.1111/j.1750-2659.2010.00183.x. [14] Remschmidt C, Wichmann O, Harder T. Influenza vaccination in HIV-infected individuals: systematic review and assessment of quality of evidence related to vaccine efficacy, effectiveness and safety[J]. Vaccine, 2014, 32(43): 5585-5592. DOI: 10.1016/j.vaccine.2014.07.101. [15] Zhang W, Sun H, Atiquzzaman M, et al. Influenza vaccination for HIV-positive people: systematic review and network meta-analysis[J]. Vaccine, 2018, 36(28): 4077-4086. DOI: 10.1016/j.vaccine.2018.05.077. -