云南省德宏州3103例艾滋病患者抗病毒治疗后生存分析

姚仕堂; 段松; 项丽芬; 叶润华; 杨跃诚; 李艳玲; 王继宝; 杨锦; 章银娣; 杨海芹; 时允; 李如娟; 翟志坚; 丁雨生; 杨卫华; 丁盈盈; 何纳

文章摘要

姚仕堂,段松,项丽芬,叶润华,杨跃诚,李艳玲,王继宝,杨锦,章银娣,杨海芹,时允,李如娟,翟志坚,丁雨生,杨卫华,丁盈盈,何纳.云南省德宏州3103例艾滋病患者抗病毒治疗后生存分析[J].中华流行病学杂志,2010,31(11):1215-1218

云南省德宏州3103例艾滋病患者抗病毒治疗后生存分析

Survival analysis on 3103 HIV/AIDS patients receiving antiretroviral treatment in Dehong prefecture, Yunnan province

收稿日期:2010-04-09 出版日期:2014-09-10

DOI：

中文关键词: 艾滋病患者抗病毒治疗生存分析

英文关键词: HIV/AIDS patient Antiretroviral treatment Survival analysis

基金项目:

作者	单位	E-mail
姚仕堂	云南省德宏傣族景颇族fi治州疾病预防控制中心潞西, 678400
段松	云南省德宏傣族景颇族fi治州疾病预防控制中心潞西, 678400
项丽芬	云南省德宏傣族景颇族fi治州疾病预防控制中心潞西, 678400
叶润华	云南省德宏傣族景颇族fi治州疾病预防控制中心潞西, 678400
杨跃诚	云南省德宏傣族景颇族fi治州疾病预防控制中心潞西, 678400
李艳玲	云南省德宏傣族景颇族fi治州疾病预防控制中心潞西, 678400
王继宝	云南省德宏傣族景颇族fi治州疾病预防控制中心潞西, 678400
杨锦	云南省德宏傣族景颇族fi治州疾病预防控制中心潞西, 678400
章银娣	德宏州医疗集团
杨海芹	陇川县人设民院
时允	潞两市人民医院
李如娟	梁河县人民保院
翟志坚	畹町民院
丁雨生	瑞丽市民族医院
杨卫华	盈江县人民厌院
丁盈盈	复口大学公共卫生学院流行病学教研窄公共卫生安全教ff部重点实验室
何纳	复口大学公共卫生学院流行病学教研窄公共卫生安全教ff部重点实验室	nhe@shmu.edu.cn

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中文摘要:

目的了解云南省德宏州艾滋病患者接受国家免费抗病毒治疗后的生存情况。方法采用回顾性研究, 对德宏州2004年7月1日至2009年12月31日接受国家免费抗病毒治疗、入组抗病毒治疗时CD4⁺T淋巴细胞计数<350个/μl、且年满16周岁的所有艾滋病患者进行分析。结果共计3103例艾滋病患者开展了抗病毒治疗, 平均年龄(36.0±9.9)岁, 62.4%是男性, 感染途径以经异性性传播为主(66.2%)。病例平均随访治疗时间为21.7个月, 绝大部分病例依从性>90%, 即平均每月漏服次数不足1~5次。抗病毒治疗后, 第1、2、3、4、5年的累计生存率分别为0.95、0.94、0.93、0.92和0.92。Cox比例风险回归模型分析发现:在控制了年龄、性别、婚姻状况等因素的潜在混杂作用影响后, 基线CD4⁺T淋巴细胞计数水平以及传播途径与其生存时间之间存在统计学关联。基线CD4⁺T淋巴细胞计数在200~350个/mm³之间死于艾滋病相关疾病的风险较基线CD4⁺T淋巴细胞计数<200个/mm³的艾滋病患者低(HR=0.16, 95%Cl：0.09~0.28)、经母婴传播等途径(不包括经异性性传播途径)感染HIV的患者死于艾滋病相关疾病的风险较经静脉注射毐品途径感染HIV者低(HR=0.35, 95%Cl:0.13~1.00)。结论免费抗病毒治疗显著提高了艾滋病患者的生存率, 较早启动抗病毒治疗有望取得更好的生存效果。

英文摘要:

Objective To determine the survival rate of HIV/AIDS patients after receiving free antiretroviral treatment in Dehong prefecture, Yunnan province. Methods A retrospective cohort analysis was conducted on all the HIV/AIDS patients aged over 16 years who had started antiretroviral treatment during January 2007 throughout December 2009 in Dehong prefecture.Results A total of 3103 HIV/AIDS patients had received antiretroviral treatment during the study period. Among them, the mean age was (36.0 ± 9, 9) years and 62.4% were males. 66.2% of them were infected with HIV through heterosexual transmission, and the mean treatment follow-up time was 21.7 months. Most patients well complied with the treatment, i.e., the average times of not taking the medicine were less than 5 per month. The cumulative survival rate of antiretroviral treatment after 1, 2, 3, 4, and 5 years were 0.95, 0.94, 0.93, 0.92, and 0.92, respectively. Data from the Cox proportional hazard regression model analysis indicated that, after adjustment for age, gender, and marital status, the baseline CD4^T cell counts and transmission route could significantly predicate the rates of survival. Those who were with baseline CD4 + T cell counts as 200-350/mm3 were less likely to die of AIDS than those with CD4 ' T cell counts <200/mm3 (Hazard Ratio or HR=0A6, 95% Cl： 0.09-0.28), and HIV-infected through mother-to-child transmission or routes other than heterosexual transmission were less likely to die of AIDS than through injecting drug use (HR=0.35, 95% Cl: 0.13-1.00). Conclusion Free antiretroviral treatment had significantly improved the survival of HIV/ AIDS patients. Earlier initiation of antiretroviral treatment was likely to have achieved better survival effects.

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