文章摘要
汤后林,李健,韩晶,许娟,毛宇嵘.2010年全国新报告HIV感染者/AIDS病例生存时间及其相关因素分析[J].中华流行病学杂志,2017,38(5):656-660
2010年全国新报告HIV感染者/AIDS病例生存时间及其相关因素分析
Survival time of newly diagnosed HIV/AIDS cases and related factors in China, 2010
收稿日期:2016-10-19  出版日期:2017-05-18
DOI:10.3760/cma.j.issn.0254-6450.2017.05.020
中文关键词: 艾滋病;生存分析;相关因素;新报告
英文关键词: AIDS;Survival analysis;Related factor;Newly reported
基金项目:
作者单位E-mail
汤后林 102206 北京, 中国疾病预防控制中心性病艾滋病预防控制中心综合防治与评估室  
李健 102206 北京, 中国疾病预防控制中心性病艾滋病预防控制中心综合防治与评估室  
韩晶 102206 北京, 中国疾病预防控制中心性病艾滋病预防控制中心综合防治与评估室  
许娟 102206 北京, 中国疾病预防控制中心性病艾滋病预防控制中心综合防治与评估室  
毛宇嵘 102206 北京, 中国疾病预防控制中心性病艾滋病预防控制中心综合防治与评估室 maoyr@chinaaids.cn 
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中文摘要:
      目的 分析全国2010年新报告HIV感染者/AIDS病例(HIV/AIDS)生存时间及影响因素。方法 使用艾滋病综合防治数据信息系统截至2015年12月31日的病例报告历史卡片和随访定时数据库,筛选出2010年新报告HIV/AIDS并整理出随访结局数据,以寿命表法计算其生存率,采用Kaplan-Meier法拟合不同状态下的生存曲线,Cox比例风险模型分析HIV/AIDS生存时间的影响因素。结果 40 335例HIV/AIDS中,11 975例因艾滋病及相关疾病死亡;截至观察终点时,中位生存时间为63.1(95%CI:63.0~63.2)个月,1年和5年生存率分别为81.2%和69.9%;多因素Cox比例风险模型分析结果显示,艾滋病死亡的风险随年龄增加而增加,25~34、35~44、45~54和≥55岁组因艾滋病死亡的风险分别是15~24岁组的1.41倍(95%CI:1.29~1.54)、1.90倍(95%CI:1.74~2.07)、2.24倍(95%CI:2.04~2.46)和2.81倍(95%CI:2.57~3.08);HIV/AIDS首次检测CD4T淋巴细胞(CD4)值≥500个/μl是CD4值<200个/μl 的0.12倍(95%CI:0.11~0.13);接受抗病毒治疗者是未接受治疗者的0.11倍(95%CI:0.10~0.12)。结论 确诊时年龄、确诊时CD4值水平、是否接受抗病毒治疗是HIV/AIDS生存时间的主要影响因素,应及早进行艾滋病检测、接受抗病毒治疗,以延长HIV/AIDS生存时间。
英文摘要:
      Objective To analyze the survival time of newly diagnosed HIV/AIDS cases and related factors in China in 2010. Methods The reporting cards and follow-up cards of HIV/AIDS cases reported as of 31 December 2015 were collected from national AIDS information system. The newly diagnosed HIV/AIDS cases in 2010 were selected. The information of follow-up intervention, CD4 T cells (CD4) testing, antiretroviral treatment and mortality of the cases from 2010 to 2015 were analyzed. Life table method was applied to calculate the survival probability. Kaplan-Meier was used to draw survival curve and Cox proportion hazard regression model were used to identify the factors related to survival time. Results Of the 40 335 HIV/AIDS cases, 11 975(29.7%) died of AIDS related diseases. The median survival time was 63.1 months (95%CI: 63.0-63.2), and the survival rates in 1 year and 5 years were 81.2% and 69.9%. Multivariate Cox regression analysis showed that the risk factors for death in the HIV/AIDS cases were age (25-34 years old vs. 15-24 years old: HR=1.41, 95%CI: 1.29-1.54; 35-34 years old vs. 15-24 years old: HR=1.90, 95%CI: 1.74-2.07; 45-54 years old vs. 15-24 years old: HR=2.24, 95%CI: 2.04-2.46; ≥55 years old vs. 15-24 years old: HR=2.81, 95%CI: 2.57-3.08). The protective factors for death in the HIV/AIDS cases were level of baseline CD4 counts (CD4≥500 cells/μl vs. CD4<200 cells/μl: HR=0.12, 95%CI: 0.11-0.13), receiving antiretroviral therapy (ART vs. no ART: HR=0.11,95%CI: 0.10-0.12). Conclusion Survival time of HIV/AIDS cases might be influenced by age, baseline CD4 count and access to antiretroviral therapy. The early diagnosed and early antiretroviral therapy could extend the survival time of HIV/AIDS cases.
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