文章摘要
李洋,王娟,贺淑芳,陈婧,卢红艳.北京市1995-2015年艾滋病病例诊断后生存时间与影响因素分析[J].中华流行病学杂志,2017,38(11):1509-1513
北京市1995-2015年艾滋病病例诊断后生存时间与影响因素分析
Survival time of HIV/AIDS cases and related factors in Beijing, 1995-2015
收稿日期:2017-04-06  出版日期:2017-11-11
DOI:10.3760/cma.j.issn.0254-6450.2017.11.014
中文关键词: 艾滋病;回顾性研究;生存分析;相关因素
英文关键词: AIDS;Retrospective studies;Survival analysis;Related factor
基金项目:
作者单位E-mail
李洋 100013 北京市疾病预防控制中心北京市预防医学研究中心性病艾滋病防治所  
王娟 100013 北京市疾病预防控制中心北京市预防医学研究中心性病艾滋病防治所  
贺淑芳 100013 北京市疾病预防控制中心北京市预防医学研究中心性病艾滋病防治所  
陈婧 100013 北京市疾病预防控制中心北京市预防医学研究中心性病艾滋病防治所  
卢红艳 100013 北京市疾病预防控制中心北京市预防医学研究中心性病艾滋病防治所 hongyan_lu@sohu.com 
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中文摘要:
      目的 分析1995-2015年北京市HIV感染者/AIDS患者(HIV/AIDS)诊断后生存时间及影响因素。方法 运用回顾性队列研究方法,对1995-2015年中国艾滋病综合防治信息系统中报告的12 874例HIV/AIDS的数据资料进行分析,应用寿命表法计算生存率,采用Cox比例风险模型分析生存时间的相关因素。结果 12 874例HIV/AIDS中,303例(2.4%)死于艾滋病及相关疾病,接受抗病毒治疗9 346例(72.6%)。平均生存时间为226.5个月(95% CI:223.0~230.1),1、5、10、15年生存率分别为98.2%、96.4%、93.2%、91.9%。Cox比例风险模型分析结果显示,艾滋病死亡风险较高的因素包括诊断时为艾滋病患者(比HIV感染者,HR=1.439,95% CI:1.041~1.989);异性传播(比同性传播,HR=1.646,95% CI:1.184~2.289);现有或曾有配偶(比未婚,HR=2.186,95% CI:1.510~3.164);诊断时年龄≥ 60岁(比≤ 30岁,HR=6.608,95% CI:3.546~12.316);诊断后首次CD4+T淋巴细胞计数(CD4)<350个/μl(比≥ 350个/μl,HR=8.711,95% CI:5.757~13.181);未抗病毒治疗(比抗病毒治疗,HR=18.223,95% CI:13.317~24.937)。结论 1995-2015年北京市HIV/AIDS诊断后的平均生存时间为226.5个月。诊断为HIV感染、同性传播、未婚、≤ 30岁、首次CD4 ≥ 350个/μl、接受抗病毒治疗的HIV/AIDS生存时间较长。相反,诊断为AIDS、异性传播、现有或曾有配偶、年龄≥ 60岁、CD4<350个/μl、未抗病毒治疗的死亡风险较高。
英文摘要:
      Objective To analyze the survival time of HIV/AIDS cases and related factors in Beijing from 1995 to 2015. Methods A retrospective cohort study was conducted to analyze the data of 12 874 HIV/AIDS cases. The data were collected from Chinese HIV/AIDS Comprehensive Information Management System. Life table method was applied to calculate the survival proportion, and Cox proportion hazard regression model were used to identify the factors related with survival time. Results Among 12 874 HIV/AIDS cases, 303 (2.4%) died of AIDS related diseases; 9 346 (72.6%) received antiretroviral therapy. The average survival time was 226.5 months (95% CI:223.0-230.1), and the survival rates of 1, 5, 10, and 15 years were 98.2%, 96.4%, 93.2%, and 91.9% respectively. Multivariate Cox proportion hazard regression model showed that AIDS phase (HR=1.439, 95% CI:1.041-1.989), heterosexual transmission (HR=1.646, 95% CI:1.184-2.289), being married (HR=2.186, 95% CI:1.510-3.164); older age (≥ 60 years) at diagnosis (HR=6.608, 95% CI:3.546-12.316); lower CD4+T cell counts at diagnosis (<350 cells/μl) (HR=8.711, 95% CI:5.757-13.181); receiving no antiretroviral therapy (ART) (HR=18.223, 95% CI:13.317-24.937) were the high risk factors influencing the survival of AIDS patients compared with HIV phase, homosexual transmission, being unmarried, younger age (≤ 30 years), higher CD4+ T cell count (≥ 350 cell/μl) and receiving ART. Conclusion The average survival time of HIV/AIDS cases was 226.5 months after diagnoses. Receiving ART, higher CD4+T cell counts at the first test, HIV phase, younger age, being unmarried and the homosexual transmission were related to the longer survival time of HIV/AIDS cases. Receiving no ART, the lower CD4+ T cell counts at the first test, AIDS phase, older age, being married and heterosexual transmission indicated higher risk of death due to AIDS.
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