| 杨文杰,李宁,梁妍,李洁,樊盼英,孙定勇,朱谦,王哲.河南省2008-2015年15岁及以上HIV/AIDS生存状况回顾性队列研究[J].中华流行病学杂志,2017,38(2):173-178 |
| 河南省2008-2015年15岁及以上HIV/AIDS生存状况回顾性队列研究 |
| A retrospective cohort study on survival status of AIDS patients among 15 or above-year-olds in Henan province, from 2008 to 2015 |
| 收稿日期:2016-08-24 出版日期:2017-02-17 |
| DOI：10.3760/cma.j.issn.0254-6450.2017.02.008 |
| 中文关键词: 艾滋病 回顾性队列 生存状况 |
| 英文关键词: HIV/AIDS Retrospective cohort Survival status |
| 基金项目:国家科技重大专项（2012ZX10004905）；河南省科技攻关计划项目 |
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| 中文摘要: |
| 目的 了解河南省HIV感染者/AIDS患者（HIV/AIDS）确诊AIDS后生存状况及其影响因素。方法 从国家艾滋病综合防治信息系统下载河南省相关数据库，筛选出2008-2015年间确诊为AIDS且≥15岁患者，进行回顾性研究。结果 纳入25 525例研究对象，观察期内病死率为24.9%，其中接受高效抗反转录病毒治疗（HAART）为14.4%。治疗比例从2008年的72.1%上升到2015年的92.8%，同期病死率从21.2%下降到4.1%，其中接受HAART者从9.2%下降到2.6%。多因素分析显示，确诊AIDS时CD4+T淋巴细胞（CD4）计数<50个/μl的患者死亡风险大（aHR=2.45）；接受HAART的患者死亡风险低（aHR=0.13）。在接受HAART患者中，有复方磺胺甲恶唑（TMP-SMZ）服用史的患者死亡风险低（aHR=0.76）；确诊AIDS时CD4计数50~个/μl组和<50个/μl组死亡风险高（aHR值分别为1.26和1.97）；基线CD4计数50~个/μl、<50个/μl组死亡风险高（aHR值分别为1.44和1.84）。结论 抗病毒治疗是影响HIV/AIDS生存时间的重要因素，加强HIV/AIDS的CD4检测，尽早纳入HAART，同时及时开展TMP-SMZ预防治疗，是减少患者AIDS相关疾病死亡的有效途径。 |
| 英文摘要: |
| Objective To explore the survival status and affecting factors among patients diagnosed as AIDS, in Henan province. Methods Database of AIDS patients were downloaded from the China information system for disease prevention and control-AIDS with a retrospective study conducted. Inclusion criteria on patients would involve those diagnosed between 2008 and 2015, aged 15 years or above. Results A total number of 25 525 HIV/AIDS patients were enrolled in this study. During the follow-up period, the overall mortality among all the patients was 24.9%. Mortality of those having received the highly active antiretroviral treatment (HAART) was 14.4%. Proportion for the treatment coverage increased gradually, from 72.1% in 2008 to 92.8% in 2015. The overall mortality rate dropped from 21.2% to 4.1% and the mortality of those having received HAART patients dropped from 9.2% to 2.6%. Results from the multiple factors analysis showed that factors as:CD4+T cell count (CD4) <50 cell/μl when the AIDS diagnosis was made (adjusted HR=2.45) were related to higher risk on mortality among HIV/AIDS patients. Patients having received HAART (adjusted HR=0.13) had lower risks on mortality. Among patients having received treatment, results from the multiple factors analysis showed that factor as TMP-SMZ dosage being administered (adjusted HR=0.76) were related to low mortality risk. As for CD4 counts of the patients, the adjusted HRs were 1.26 in 50-cells/μl group and 1.97 in the <50 cells/μl group, respectively when the diagnosis was made. Both groups had high risk on mortality patients with lower baseline CD4 counts (adjusted HR were 1.44, 1.84 in 50-cells/μl and <50 cells/μl groups, respectively) seemed to have higher risk on mortality. Conclusions Antiretroviral therapy appeared an important factor that affecting the survival of HIV/AIDS patients. CD4 count test, early identifying and treating the AIDS patients together with providing TMP-SMZ prevention and treatment programs, were important approaches in extending the survival time so as to reduce the death rates from AIDS related illnesses. |
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